National Certification Corporation (NCC)



National Certification Corporation (NCC)Obstetric and Neonatal Quality and Safety Sub-Specialty Certification Examination Practice Analysis StudyTina Freilicher, Ph.D., Shoreline Psychometric Services, LLC.Table of Contents TOC \o "1-3" \h \z \u Introduction PAGEREF _Toc531676004 \h 4Methodology PAGEREF _Toc531676005 \h 4Rationale for the Methodology PAGEREF _Toc531676006 \h 4Role of the Practice Analysis Committee PAGEREF _Toc531676007 \h 6Development of the Practice Analysis PAGEREF _Toc531676008 \h 6Pilot Testing the Survey PAGEREF _Toc531676009 \h 10Survey Sampling Plan and Dissemination of the Survey PAGEREF _Toc531676010 \h 10Results PAGEREF _Toc531676011 \h 11Survey Response Rate PAGEREF _Toc531676012 \h 11Respondents’ Background and Demographic Information PAGEREF _Toc531676013 \h 14Analysis of Practice Analysis Data PAGEREF _Toc531676014 \h 19Finalization of the Content Outline PAGEREF _Toc531676015 \h 26Finalization of the Test Weights PAGEREF _Toc531676016 \h 29Survey Respondents’ Opinion about Eligibility and Continuing Education Requirements PAGEREF _Toc531676017 \h 33Interest in the Credential PAGEREF _Toc531676018 \h 34Summary and Recommendations PAGEREF _Toc531676019 \h 35Index of Tables TOC \c "Table" Table 1. Practice Analysis Committee Members’ Demographic and Background Information PAGEREF _Toc531676022 \h 6Table 2. Validity Rating Scales for Major Domains of Practice PAGEREF _Toc531676023 \h 7Table 3. Validity Rating Scales for the Task Statements PAGEREF _Toc531676024 \h 8Table 4. Validity Rating Scale for the Knowledge Statements PAGEREF _Toc531676025 \h 8Table 5. Survey Response Rate PAGEREF _Toc531676026 \h 11Table 6. Survey Respondents’ Multiple Credentials PAGEREF _Toc531676027 \h 12Table 7. Survey respondents’ credentials PAGEREF _Toc531676028 \h 13Table 8. Nurse leadership title PAGEREF _Toc531676029 \h 14Table 9. Primary Role PAGEREF _Toc531676030 \h 14Table 10. Primary Role: Summary of “Other Please Specify” Responses PAGEREF _Toc531676031 \h 15Table 11. Practice Setting PAGEREF _Toc531676032 \h 15Table 12. Types of APRN as primary role PAGEREF _Toc531676033 \h 15Table 13. OB Designation PAGEREF _Toc531676034 \h 15Table 14. NICU designation PAGEREF _Toc531676035 \h 16Table 15. Highest level of education PAGEREF _Toc531676036 \h 16Table 16. Hours worked per week PAGEREF _Toc531676037 \h 16Table 17. Number of years in current role PAGEREF _Toc531676038 \h 17Table 18. Areas of current practice areas PAGEREF _Toc531676039 \h 17Table 19. State/Country of Residence PAGEREF _Toc531676040 \h 17Table 20. Place of residence “Other (please specify)” PAGEREF _Toc531676041 \h 18Table 21. Task Statements Importance and Frequency Ratings – Descriptive Statistics PAGEREF _Toc531676042 \h 19Table 22. Domains - Importance Ratings and Time Spent PAGEREF _Toc531676043 \h 23Table 23. Knowledge Statements - Criticality Ratings PAGEREF _Toc531676044 \h 24Table 24. Three Sets of Preliminary Test Specifications PAGEREF _Toc531676045 \h 29Table 25. Survey Respondents' Mean Percentage of Test Questions Per Domain PAGEREF _Toc531676046 \h 30Table 26. Final test specifications based on job (practice) analysis data PAGEREF _Toc531676047 \h 32Table 27. Survey respondents’ opinion about eligibility requirements PAGEREF _Toc531676048 \h 34Table 28. Survey respondents’ opinion about continuing education requirements PAGEREF _Toc531676049 \h 34Table 29. Interest in seeking the credential PAGEREF _Toc531676050 \h 34Table 30. Benefits of the credential PAGEREF _Toc531676051 \h 35Table 31. Task Statements Importance Validity Scale - Counts & Percentages PAGEREF _Toc531676052 \h 55Table 32. Task Statements – Frequency Validity Rating Scale – Counts & Percentages PAGEREF _Toc531676053 \h 57Table 33. Survey respondents’ comments about the task statements PAGEREF _Toc531676054 \h 60Table 34. Survey respondents' comments about the major domains of practice PAGEREF _Toc531676055 \h 72Table 35. Knowledge Statements – Criticality Rating Scale – Counts & Percentages PAGEREF _Toc531676056 \h 77Table 36. Survey respondents' comments about the knowledge statements PAGEREF _Toc531676057 \h 81Table 37. Survey respondents’ comments about eligibility requirements PAGEREF _Toc531676058 \h 93Table 38. Survey respondents’ comments about continuing education requirements PAGEREF _Toc531676059 \h 101Table 39. Likelihood in seeking the credential – responses to open-ended question PAGEREF _Toc531676060 \h 107Table 40. Benefits of the credential – responses to Other(please specify) PAGEREF _Toc531676061 \h 121Appendix TOC \c "Appendix" Appendix A. Psychometrician's qualifications PAGEREF _Toc531676062 \h 36Appendix B. Agenda for job analysis meeting PAGEREF _Toc531676063 \h 37Appendix C. Demographic/background questions: verbatim responses to “Other, please specify” option PAGEREF _Toc531676064 \h 39Appendix D. Task Statements Importance and Frequency Validity Scales – Counts & Percentages PAGEREF _Toc531676065 \h 55Appendix E. Survey respondents' comments about the task statements PAGEREF _Toc531676066 \h 60Appendix F. Survey respondents’ comments about the major domains of practice PAGEREF _Toc531676067 \h 72Appendix G. Knowledge statements: criticality validity scale – counts & percentages PAGEREF _Toc531676068 \h 77Appendix H. Survey respondents' comments about the knowledge statements PAGEREF _Toc531676069 \h 81Appendix I. Agenda for review of job analysis results PAGEREF _Toc531676070 \h 85Appendix J. Final content outline PAGEREF _Toc531676071 \h 87Appendix K. Survey respondents’ comments about eligibility requirements PAGEREF _Toc531676072 \h 93Appendix L. Survey respondents’ comments about continuing education requirements PAGEREF _Toc531676073 \h 101Appendix M. Interest in the credential and perceived benefits – responses to open-ended questions PAGEREF _Toc531676074 \h 107National Certification CorporationObstetric and Neonatal Quality and Safety Sub-Specialty Certification Examination Practice Analysis StudyIntroductionIn 2018, the National Certification Corporation (NCC) conducted a practice analysis study for the development and implementation of a practice-based Obstetric and Neonatal Quality and Safety Sub-Specialty Certification Examination. This is a new sub-specialty certification examination that will be offered by the NCC. The study resulted in the identification of the major domains of practice, the tasks associated with the domains, and the knowledge applied in the performance of the tasks. This information was used to develop a content outline and test specifications for the certification examination. In January 2018, the NCC retained the services of Dr. Tina Freilicher, Ph.D. of Shoreline Psychometric Services, LLC. for assistance in the conduct of a practice analysis study (i.e., referred to as the “consultant” in this report). Dr. Tina Freilicher, who is psychometrician, facilitated the meetings, analyzed the data, and prepared this report. See Appendix A for a description of Dr. Freilicher’s qualifications. The study was conducted to develop a content outline and test specifications for the examination that would reflect current, best practice of obstetric and neonatal quality and safety. This report describes the study’s methodology, summarizes data, and presents the results of the study, i.e. a draft content outline and preliminary test specifications presented to the NCC for review and finalization. MethodologyRationale for the MethodologyPractice analysis methodologies including both empirical and logical were considered. Although the two methodologies differ in many ways, a critical difference is that empirical practice analyses are essentially survey-based and depend on a broad sampling of practitioners. Logical job analyses are focus group-based and depend on the pooled judgments of a representative committee of subject-matter experts (SMEs). It is, in essence, a “brainstorming” process that proceeds until consensus is reached on each point under investigation or discussion. One of the more formal names for the brainstorming employed in the context of job analysis is “role delineation.” The purpose of role delineation, as a job task analysis technique, is to develop practice-based test specifications for the certification-level professional. It achieves this goal by identifying the major and specific work activities (tasks) that define the profession along with the knowledge required of the certification-level candidate. A combination of the logical and empirical practice analysis methodologies was chosen for the following reasons:1) The availability of sufficient qualified SMEs from which to select a focus group committee.2) Using a combination of these data collection methodologies will complement each approach, as the logical approach will contribute to the development of a content outline that would be validated by a larger sample of the population. The procedure used involved a number of steps including:1) Identification, development and review of the major domains of practice.2) Identification, development and review of the task statements associated with the domains.3) Identification, development and review of the knowledge statements.4) Development of domain weights.5) Preparation of final test specifications. The following is a brief outline of each of the steps as employed in this practice analysis study:1. The major domains of practice were developed as they are the principal areas of responsibility or activity that comprise the sub-specialty practice of obstetric and neonatal quality and safety. They are the major headings in the outline format of the test specifications document.2. After the development of the domains, the next step was to identify and develop the tasks associated with each domain. A task is defined as a specific, goal-directed activity or set of activities having a common objective or type of output. The set of tasks for each domain was delineated in such a manner as to be exhaustive and mutually exclusive and cover all aspects of the profession relevant to the objectives of the job task analysis (i.e., the development of practice-based test specifications).3. The committee developed the finalized domains and tasks while ensuring clarity of meaning and comprehensiveness.4. The committee developed the knowledge statements associated with the performance of each task. 5. The committee reviewed the knowledge statements to ensure clarity of meaning and comprehensiveness, and aligned the knowledge statements to the task statements.A survey of the content outline was then disseminated to the population of professionals in the area of obstetrics and neonatal. Using an importance validity rating scale and an indication of the percentage of time spent performing tasks in the major domains of practice, as well as the application of importance and frequency validity rating scales for the task statements, the survey respondents’ ratings were used to derive a set of weights for the draft test specifications.Role of the Practice Analysis CommitteeAs the first step, the NCC convened a representative committee of subject matter experts (i.e., the practice analysis committee) in the practice of sub-specialty practice of obstetric and neonatal quality and safety for the development of the practice analysis. Their role in the study was to develop the content outline, describing the major domains of practice, the tasks associated with the domains and the knowledge necessary to perform the tasks. The committee also developed questions for the survey, reviewed the survey instrument, and used the data resulting from the study to finalize the content outline and test specifications. See Table 1 below for the roster of the committee of experts. Table SEQ Table \* ARABIC 1. Practice Analysis Committee Members’ Demographic and Background Information NamePosition, TitleSpecialtyRegionGautham Suresh, MD,DM, MS, FAAPSection Head and Service Chief, Neonatology, Baylor College of Medicine, Texas Children’s HospitalNeonatologyHouston, TX (Region 3)Tami Wallace, DNP, APRN, NNP-BCNeonatal Nurse Practitioner; Neonatal Allied Nationwide Children’s HospitalNeonatal Columbus, Ohio (Region 2)David McLean, MD, MPH, FACOG, C-EFMMedical Director of Maternal Fetal Center at Valley Children’s Hospital; Vice –President NCCMaternal-Fetal Medicine, ObstetricsMadera, CA (Region 4)Danielle Felty, MSN, RN, NEA-BC, RNC-OB, C-EFMDirector of Maternal/Child; Liberty HospitalMaternal Child and Inpatient ObstetricsLiberty, MO (Region 2)Andrew Combs, MD, PhDDirector of Quality for Maternal-Fetal Medicine; MEDNAX Obstetrix Medical Group,Maternal-Fetal Medicine; ObstetricsCampbell, CA (Region 4)Catherine Ivory, PhD, RNC-OB, RN, BCIndiana University HealthInpatient Obstetrics and Perinatal Indiana, (Region 2)Kathleen Simpson PhD, RNC-OB, CSN-BC, FAANPerinatal Clinical Nurse Specialist, Mercy HospitalPerinatal Care, Q&S, EFMSt. Louis Missouri (Region 2)Patricia Scott, DNP, APRN, NNP-BC, C-NPTPediatrix Medical Group of TN, Advanced Practitioner Coordinator, NNP, Coordinator of Neonatal Transport Service. Infant Quality Improvement Specialist, TIPQC. Neonatology, TransportNashville, TN (Region 3)David Annibale, MDMedical University of South Carolina, Director of Neonatology. Professor of Pediatrics. Associate Member of the College of Nursing Faculty. NeoReviews Plus Editorial Staff AAP. NeonatologyCharleston, SC (Region 3)Katharine E. Donaldson, MSN, WHNP-BC, RNC-OB, CPLS, C-EFMPerinatal Clinical Nurse Specialist, Capital Health System; Pennington and Trenton, NJObstetrics, Women’s HealthHolland, PA(Region 1)Denise Zayack, RN, MSDivision of Quality Improvement and Education, Vermont Oxford NetworkNeonatologyVermont (Region 1)Suzanne Staebler, DNP, APRN, NNP-BC, FAANPClinical Professor, Nell Hodgson Woodruff School of Nursing, Emory University, President NCCNeonatal Atlanta, GA (Region 3)Sue Kendig, JD, MSN, WHNP-BCHealth Policy Advantage, LLCWomen’s HealthKim L. Armour, PhD, NP-BC, RDMS, NEA-BCDirector of Operations, Women’s Obstetric & Neonatal Services. Prentice Women’s Hospital. Northwestern Memorial Healthcare System.Obstetrics, Women’s HealthChicago, Il (Region 2)Peter Bernstein, MD, MPHDirector, Division of Maternal Fetal Medicine, Professor of Clinical Obstetrics & Gynecology and Women’s Health. Albert Einstein College of Medicine, Montefiore Medical Center.Maternal-Fetal Medicine, ObstetricsBronx, NY (Region 1)Megan Cunningham, MSN RN, CPHQSafety Quality Specialist at the Children’s Hospital of PhiladelphiaCardiac and Special DeliveryPhiladelphia, PN (Region 1)Development of the Practice AnalysisIn preparation for an in-person meeting with the practice analysis committee, the consultant prepared a draft content outline using information about the sub-specialty practice provided by the NCC. The information provided were objectives and a preliminary content outline for the sub-specialty exam program, and a preliminary listing of topics associated with the sub-specialty. The information was used to draft the major domains of practice, tasks associated with the major domains, and knowledge that may be used to perform the tasks. The consultant also drafted demographic/background questions, validity rating scales, questions addressing eligibility and continuing education requirements for the practice analysis survey instrument. The practice analysis committee met on February 8-9, 2018 to develop the content outline describing the major domains of practice, task and knowledge statements. They were provided an orientation to the process of a practice analysis and then worked as a full group to identify the major domains of practice. To assist them in this effort, they were provided with the draft content outline. After the committee identified the major domains of practice, they worked in small groups to develop task and knowledge statements for the small group’s assigned domain(s). They later reconvened as a full group to review the entire document. (See Appendix B for the meeting agenda.)The committee developed a content outline that consisted of the following five major domains of practice:Domain 1: Systematically perform ongoing and comprehensive quality and safety assessment and gap analysesDomain 2: Promote the integration of quality and safety practices within the organization at the governance and leadership levels.Domain 3: Develop and implement quality and safety initiatives in obstetric and neonatal practice.Domain 4: Evaluate and measure the effectiveness of quality and safety practices in obstetric and neonatal careDomain 5: Professionalism and ethical practiceA total of 21 task statements were identified and were distributed among the major domains of practice as follows: Domain 1: three (3) task statements, Domain 2: five (5) task statements, Domain 3: five (5) task statements, Domain 4: three (3) task statements, and Domain 5: five (5) task statements. Sixty-eight (68) knowledge statements were identified and aligned to individual task statements. The following validity rating scales were reviewed and used to validate the major domains of practice (see Table 2), the task statements (see Table 3) and the knowledge statements (see Table 4). The scales are designed to collect data on the importance of the domains of practice in the area of sub-specialty of obstetric and neonatal quality and safety, the importance of the quality and safety tasks performed in professional practice, and the criticality of the knowledge for work in the area of quality and safety. In addition to the importance validity ratings for the domains, survey respondents were asked to indicate the percentage of time spent performing tasks in each major domain of practice. For the task statements, in addition to applying an importance validation rating, survey respondents were also asked to use a frequency validity rating scale to indicate the frequency in which tasks are performed in their professional practice of quality and safety.Table SEQ Table \* ARABIC 2. Validity Rating Scales for Major Domains of PracticeHow important is this major domain in your practice of quality and safety?Not importantSomewhat importantImportantVery importantWhat is the approximate percentage of time spent performing tasks in each of the following major domains? Table SEQ Table \* ARABIC 3. Validity Rating Scales for the Task StatementsHow important is this quality and safety task in your professional practice?Not importantSomewhat importantImportantVery ImportantHow frequently do you perform this quality and safety task in your professional practice?Never - I do not perform this task Rarely - Once or twice per year Occasionally – Every 2 to 6 monthsRoutinely – At least once a monthFrequently – At least once a weekTable SEQ Table \* ARABIC 4. Validity Rating Scale for the Knowledge StatementsHow critical is this knowledge for your work in quality and safety practice?Not criticalSomewhat criticalCriticalVery criticalFollowing the February 8-9, 2018 meeting with the practice analysis committee, the content outline was sent to the practice analysis committee in advance of a web conference that was held on April 6, 2018. The purpose of the web conference was to conduct a final review of the content outline before the development of the survey instrument. In preparation for the web conference, the committee was provided with the following set of instructions for reviewing the document:INSTRUCTIONS FOR REVIEWING THE CONTENT OUTLINE:The intent of the review is to ensure that the content outline is comprehensive and accurate. Please consider the following as you review the content outline:Major Domains:Are the major domain statements accurate? If not, please edit to make them accurate.Task Statements:Are the task statements accurate? If not, please edit to make them accurate.Are there duplicate or similar task statements that can be removed/consolidated? If so, please indicate the task statements that should be removed and for those that can be consolidated, please consolidate the statements.Are any task statements missing from the outline? If so, please add them to the appropriate domain. When reviewing task statements, please keep in mind, to the extent possible, the task statement should address the following: what task is being performed, how is it being performed, and why is it being performed? The statement should begin with an action verb. Knowledge Statements:Please see instructions for how to review the knowledge statements on page 9 of this document.INSTRUCTIONS FOR REVIEWING THE KNOWLEDGE STATEMENTS: The knowledge statements below are listed in two ways. The knowledge statements presented in the first list are in the same sequence as they appear in the content outline. The second list presents the knowledge statements in alphabetical order. (The second list is provided to help in identifying any duplicate or similar knowledge statements.) Please review the knowledge statements for the following:Are the knowledge statements accurate? If not, please revise the statements to clarify.Are any knowledge statements missing? If so, please add them to the content outline following the task(s) that requires the knowledge. (Do not add them to the following lists.)Are any of the knowledge statements very similar? It is recommended that “similar” statements be consolidated, or the best one be selected and the other statements be deleted. Some similar statements are highlighted in yellow on the list that presents the knowledge statements in alphabetical order.In the case of duplicate statements, please keep in mind that a knowledge statement may be applicable to more than one task statement within a domain or applicable to tasks in other domains. Therefore, there may be a few instances in which a knowledge statement is listed more than once, and that’s okay. Those statements will be renumbered and only one of the duplicate statements will appear on the survey. When editing and/or consolidating knowledge statements, you may make your edits using track changes, or highlight your edits. If you do consolidate knowledge statements, please indicate the knowledge statements that should be deleted by either using track changes (i.e., strikeout), or adding, “Delete” following the statements. The committee was asked to provide their feedback/suggested revisions in advance of the web conference that was scheduled for April 6, 2018. The committee members’ feedback/comments were added to a “master” document (i.e., the content outline showing all committee members’ comments and suggested revisions) and was shared with the committee during the web conference. The web conference was facilitated by the consultant and NCC. The web conference resulted in making additional revisions to the content outline to clarify statements and to remove redundancies.Pilot Testing the SurveyThe consultant provided the NCC with a mock-up of the survey instrument that the NCC would use to develop the survey in their survey software. The NCC was responsible for disseminating the survey. On May 18, 2018, the NCC piloted the survey by disseminating it the ONQS Job Analysis Team and the INPT, NIC, LRN and EFM content teams. There were 48 participantsThe results of the pilot test did not result in altering the practice analysis survey.The survey was structured so that the first section of the survey included the majority of the demographic/background questions, followed by the sections that presented the components of the content outline for validation, questions to collect data on the survey respondents’ opinions concerning eligibility and continuing education requirements, and interest in the credential, and the perceived value of the credential. The last section of the survey presented the remaining demographic/background questions. Survey Sampling Plan and Dissemination of the SurveySince the sub-specialty of quality and safety in obstetrics and neonatal care units and facilities is a new certification examination program, the NCC decided to disseminate the survey as broadly as possible with the intent of obtaining a representative sample of survey respondents from a variety of geographic locations, roles in the obstetric and neonatal care units and facilities, and types of units and facilities. On July 18, 2018, the NCC disseminated the survey to approximately 108,245 individuals for review and comment (i.e. validation). Of the 108,245 individuals who were sent the survey, 88,800 held NCC certifications and 19,445 individuals held certifications with three (3) other certifying bodies. Links to the survey were posted by the American Association for Respiratory Care and the Association of Women’s Health, Obstetric and Neonatal Nurses. See the next section for more information about the survey respondents.The survey recipients were asked to complete the survey by August 20, 2018. The NCC emailed reminders to complete the survey to non-respondents on (July 27 and 30th; August 4 and 7th, 2018). The survey was closed on August 20, 2018. The NCC exported the survey data in an Excel file and provided it to Shoreline Psychometric Services, LLC. for analysis, the results of which can be found below. The results were used and considered by the NCC in the finalization of the content outline and test specifications. The final determination of the changes to the practice analysis (i.e., content outline and test specifications) were determined by the NCC. ResultsThis section of the report presents the results of the survey. It presents the results of the background and demographic questions, and the results of the validation ratings of the major domains, tasks, and knowledge statements. Survey Response RateThe survey was emailed to 88,800 individuals who hold NCC credentials via the survey software, and a link to the survey was emailed to an additional 19,445 who hold credentials with the following certifying bodies: ACNM, AMA, and Perinatal QI. A total of 13,625 individuals responded to the survey. To identify professionals who perform work in obstetrical and neonatal care units or facilities, the following screening question was presented at the onset of the survey. “Do you provide clinical coverage, education, training, research or oversight in Obstetrical or Neonatal Care units or facilities?”Of the 13,625 survey respondents, 10,676 (78.36%) responded “Yes” to the screening question. Those who responded “No” to the question (2,949, or 21.64%) were exited from the survey, as they did not meet the criteria for being identified as working in obstetrical and neonatal care units or facilities. Of the 10,676 survey respondents who met the criteria to take the survey, an assessment was made of their completion rate. Some of the respondents did not reply to all questions. The number of respondents (N) for each question is indicated in the tables described in this section of the report. Table SEQ Table \* ARABIC 5. Survey Response Rate?Survey Response Rate by GroupGroupSent invitesUnopened or bouncedReceived invitesRespondentsResponse RateIncluded in AnalysisN%N%N%N%%N%NCC Certified INP group 19,99711.26%3,7588.02%6,23914.87%1,95020.19%31.26%??NCC Certified INP group 29,99811.26%3,6487.79%6,35015.14%1,64617.04%25.92%??NCC Certified MNN 1 and LRN9,98511.24%3,7988.11%6,18714.75%1,56416.19%25.28%??NCC Certified NIC group 19,97911.24%3,8958.31%6,08414.50%1,46615.18%24.10%??NCC Certified NIC group 2 & NNP9,97111.23%3,5767.63%6,39515.24%1,41814.68%22.17%??NCC Certified C-EFM & C-NPT9,66810.89%4,1888.94%5,48013.06%1,12911.69%20.60%??Mixed Phys -Neo-MF-OB?9,23310.40%5,90612.61%3,3277.93%3573.70%10.73%??OB Phys group 1?9,98011.24%9,05619.33%9242.20%550.57%5.95%??OB Phys group 29,98911.25%9,02419.26%9652.30%740.77%7.67%??Total88,800100%46,849100%41,951 100%9,659100%23.02%4,20644%?Confidence Interval (CI) at 95% confidence level0.87 1.43Emailed WeblinksACNM6,52833.57%N/A N/A 6,52833.57%25 49.33%3.95%??AMA6,91735.57% N/A N/A 6,91735.57%71.34%0.10%??Perinatal QI6,00030.86%N/A N/A 6,00030.86%25849.33%4.30%??Total19,445100% N/A N/A 19,445100%523100%2.69%CI 4.23Posted WeblinksRRTs1 N/A N/A N/A 1 N/A 3,38898.46% N/A ??AWHONN1 N/A N/A N/A 1 N/A 531.54% N/A ??Total2N/AN/AN/A2N/A3,441100%1,99858%Grand Total108,245 N/A N/A N/A 61,396 N/A 13,623 100%22.19%6,20446%Table SEQ Table \* ARABIC 6. Survey Respondents’ Multiple CredentialsCredentialsAll survey respondents who responded to the screening question.All survey respondents who proceeded to complete the survey.N%N%C-BF, NNP-BC 1 0.01% 1 0.02%C-EFM 735 5.39% 297 4.79%C-EFM, RNC-HROB 1 0.01% - 0.00%C-EFM, RNC-LRN 1 0.01% - 0.00%C-EFM, RNC-MNN 29 0.21% 14 0.23%C-EFM, RNC-OB 493 3.62% 224 3.61%C-EFM, RNC-OB, RNC-LRN 1 0.01% - 0.00%C-EFM, RNC-OB, RNC-LRN, RNC-MNN 4 0.03% 1 0.02%C-EFM, RNC-OB, RNC-MNN 18 0.13% 8 0.13%C-EFM, RNC-OB, RNC-NIC 1 0.01% - 0.00%C-EFM, RNC-OB, WHNP-BC 1 0.01% - 0.00%C-EFM, RNC-TNP 1 0.01% - 0.00%C-NPT 55 0.40% 20 0.32%CNM, C-EFM 13 0.10% 6 0.10%DO, C-EFM 2 0.01% - 0.00%MD, C-EFM 44 0.32% 24 0.39%MD, C-NPT 1 0.01% - 0.00%NM, RNC-MNN 1 0.01% - 0.00%NNP-BC 843 6.19% 434 7.00%NNP-BC, RNC-NIC 21 0.15% 5 0.08%NNP-BC, RNC-OB 1 0.01% - 0.00%NNP-BC, RNC-OB, RNC-MNN, C-EFM 1 0.01% - 0.00%PA, C-EFM 2 0.01% 1 0.02%PCM, RNC-MNN 1 0.01% - 0.00%RN 1 0.01% - 0.00%RN, C-EFM 229 1.68% 90 1.45%RN, C-NPT 20 0.15% 9 0.15%RNC-HROB, C-EFM 6 0.04% 2 0.03%RNC-HROB, RNC-OB 1 0.01% - 0.00%RNC-HROB, RNC-OB, C-EFM 3 0.02% 3 0.05%RNC-LRN 419 3.08% 191 3.08%RNC-LRN, C-BF 2 0.01% 1 0.02%RNC-LRN, C-EFM 1 0.01% - 0.00%RNC-LRN, NNP-BC 1 0.01% 1 0.02%RNC-LRN, RNC-MNN 4 0.03% 1 0.02%RNC-LRN, RNC-NIC 16 0.12% 9 0.15%RNC-LRN, RNC-NIC, NNP-BC 1 0.01% 1 0.02%RNC-MNN 1,087 7.98% 400 6.45%RNC-MNN, C-NPT 1 0.01% - 0.00%RNC-MNN, RNC-OB 5 0.04% 3 0.05%RNC-MNN, RNC-OB, C-EFM 2 0.01% 1 0.02%RNC-NIC 1,953 14.33% 882 14.22%RNC-NIC, NNP-BC 59 0.43% 30 0.48%RNC-NIC, RNC-LRN 1 0.01% - 0.00%RNC-NIC, RNC-OB 1 0.01% 1 0.02%RNC-NIC, RNC-TNP 1 0.01% - 0.00%RNC-NIC, WHNP-BC 2 0.01% 1 0.02%RNC-OB 2,553 18.74% 1,053 16.97%RNC-OB, C-EFM 391 2.87% 201 3.24%RNC-OB, C-EFM, RNC-MNN 1 0.01% 1 0.02%RNC-OB, RNC-LRN 2 0.01% 1 0.02%RNC-OB, RNC-MNN 11 0.08% 4 0.06%RNC-OB, RNC-MNN, WHNP-BC 1 0.01% - 0.00%RNC-OB, RNC-NIC 2 0.01% 2 0.03%RNC-OB, RNC-TNP 2 0.01% - 0.00%RNC-OB, WHNP-BC 37 0.27% 16 0.26%RNC, C-EFM 1 0.01% 1 0.02%RRT, C-NPT 1 0.01% - 0.00%RT, C-NPT 13 0.10% 6 0.10%WHNP-BC 1 0.01% - 0.00%WHNP-BC, RNC-OB 25 0.18% 9 0.15%WHNP-BC, RNC-OB, C-EFM 17 0.12% 9 0.15%Total 9,145 67.11% 3,964 63.89%Blank 4,481 32.89% 2,240 36.11%Grand Total 13,626 100.00% 6,204 100.00%Table SEQ Table \* ARABIC 7. Survey respondents’ credentialsCredentialSurvey respondents who met the criteria to take the surveySurvey respondents who proceeded to take the surveyN%N%C-BF3 0.03%2 0.04%C-EFM1,998 18.67%883 18.88%C-NPT91 0.85%35 0.75%CNM13 0.12% 6 0.13%DO2 0.02%00.00%MD45 0.42%24 0.51%NM 1 0.01%00.00%NNP-BC928 8.67%472 10.09%PA2 0.02%1 0.02%PCM1 0.01%00.00%RN250 2.34%99 2.12%RNC1 0.01%1 0.02%RNC-HROB11 0.10%5 0.11%RNC-LRN453 4.23%206 4.41%RNC-MNN1,166 10.90%433 9.26%RNC-NIC 2,058 19.24%931 19.91%RNC-OB3,574 33.40%1,537 32.87%RNC-TNP4 0.04%00.00%RRT1 0.01%00.00%RT13 0.12%6 0.13%WHNP-BC84 0.79%35 0.75%Total10,699 100.00%4,676 100.00%Respondents’ Background and Demographic InformationThe background and demographic questions were designed to collect data about the survey respondents’ credentials (i.e., certifications/licenses), job title, primary job roles, practice settings, years of experience, gender, age range, geographical location, and highest level of education, number of hours worked per week, etc. Tables 8 – 20 present the results of the background and demographic questions. See Appendix C for responses to “Other (please specify).” Table SEQ Table \* ARABIC 8. Nurse leadership titleNurse leadership titleTitleN%Chief nursing officer70.90%Director20225.93%Manager53969.19%Nurse Executive303.85%Response10.13%Total779100.00%Table SEQ Table \* ARABIC 9. Primary RoleWhat is your primary role (i.e., where you spend the majority of your time)?RoleN%Administrative62210.03%Clinical practice462574.55%Educator/Instructor/Professor64510.40%Researcher350.56%Social Work/Outreach40.06%Other (please specify)2734.40%Total6204100.00%Table SEQ Table \* ARABIC 10. Primary Role: Summary of “Other Please Specify” ResponsesWhat is your primary role (i.e., where you spend the majority of your time)? OTHER Roles*ResponsesN%Bedside Nurse155%Charge Nurse166%Clinical Informaticist31%Clinical Supervisor31%CNS Role31%Floor RN41%Quality (see comments at the end of the comment table)228%Single Letters (e.g., I, J, K, O, P, S)93%Staff Nurse114%Team Leader21%Unit Coordinator 21%Other roles*18367%Total273100%*See Appendix C for verbatim responses.Table SEQ Table \* ARABIC 11. Practice SettingWhich of the following best describes your practice setting?Practice SettingN%Academic setting2984.80%Birthing center560.90%Community clinic771.24%Hospital549488.56%Private practice1542.48%Research Center30.05%Other (please specify)*1221.97%Total6204100.00%*See Appendix C for verbatim responses to “Other (please specify).”Table SEQ Table \* ARABIC 12. Types of APRN as primary roleWhich of the following types of APRN is your primary role?APRNN%Certified Nurse-Midwife24016.82%Clinical Nurse Specialist18613.03%Neonatal Nurse Practitioner65245.69%Pediatric Nurse Practitioner50.35%Women’s Health Nurse Practitioner443.08%Other (please specify)*30021.02%Total1427100.00%*See Appendix C for verbatim responses to “Other (please specify).”Table SEQ Table \* ARABIC 13. OB DesignationIf you work in OB, which of the following describes its designation? (Choose the highest level you cover and spend the majority of time in or oversee).DesignationN%Birth Center (Peripartum care of low-risk women with uncomplicated singleton term pregnancies with a vertex presentation who expect an uncomplicated birth)761.23%Do not know761.23%Level I (Basic Care) Uncomplicated pregnancies with ability to detect, stabilize and initiate management of unanticipated maternal-fetal or neonatal problems and transfer as needed6169.93%Level II (Specialty Care) Level I facility plus care of appropriate high-risk antepartum, intrapartum or postpartum conditions both directly admitted or transferred in114618.47%Level III (Subspecialty Care) Level II facility plus care of more complex maternal conditions, obstetric complications and fetal conditions. Advanced imaging110817.86%Level IV (Regional Health Care Centers) Level III facility plus on-site medical and surgical care of the most complex maternal conditions and critically ill pregnant women and fetuses throughout antepartum, intrapartum and postpartum. Onsite ICU care, maternal referral and transport, outreach126520.39%Non-applicable191730.90%Total6204100.00%Table SEQ Table \* ARABIC 14. NICU designationIf you work in an NICU, which of the following describes its designation?DesignationN%Do not know200.32%Level I (Basic care)1712.76%Level II (Specialty care for newborns at 32 weeks’ gestation or more, weighing 1500 g or more with problems expected to resolve rapidly or who are convalescing from higher level care)5979.62%Level III (Subspecialty care for high-risk newborns needing continuous life support and comprehensive care for critical illness. Includes infants weighing less than 1500 g or less than 32 weeks’ gestation at birth)154924.97%Level IV (Includes level III care as well as on-site pediatric medical and surgical subspecialties to care for infants with complex congenital or acquired conditions, coordinate transport systems and outreach education)111117.91%Non-applicable275644.42%Total6204100.00%Table SEQ Table \* ARABIC 15. Highest level of educationWhat is your highest level of education?EducationN%Associate67910.94%Baccalaureate253840.91%Doctorate - PhD761.23%Doctorate - DNP2183.51%High School Diploma40.06%Masters188330.35%MD/DO3786.09%Post Masters1692.72%Other (please specify)*2594.17%Total6204100.00%*See Appendix C for verbatim responses to “Other (please specify).”Table SEQ Table \* ARABIC 16. Hours worked per weekHow many hours a week do you work (clinical practice, education, research and administration combined)?HoursN%Less than 20 hours1973.18%20-34 hours109717.68%35 hours or more487378.55%Not employed at this time140.23%Retired230.37%Total6204100.00%Table SEQ Table \* ARABIC 17. Number of years in current roleHow long have you been in your current role?YearsN%Less than a year2473.98%1-5 years131221.15%6-10 years99616.05%11-15 years88714.30%16-20 years73711.88%More than 20 years202532.64%Total6204100.00%Table SEQ Table \* ARABIC 18. Areas of current practice areasWhat areas does your current practice incorporate? (Check all that apply)AreaNAntepartum3225Postpartum3367Newborn3786Neonatal3429Education2492Labor and Delivery3698Management/Administration1350Private practice obstetrics345Research632Other (please specify)*307*See Appendix C for verbatim responses.Table SEQ Table \* ARABIC 19. State/Country of ResidenceIn what state do you live?StateN%Alabama470.76%Alaska200.32%American Samoa10.02%Arizona1472.37%Arkansas530.85%California5679.14%Colorado1582.55%Connecticut941.52%Delaware260.42%District of Columbia (DC)50.08%Florida3105.00%Georgia1822.93%Guam50.08%Hawaii270.44%Idaho400.64%Illinois2814.53%Indiana1141.84%Iowa580.93%Kansas450.73%Kentucky651.05%Louisiana1011.63%Maine310.50%Maryland1702.74%Massachusetts811.31%Michigan1832.95%Minnesota801.29%Mississippi310.50%Missouri1031.66%Montana220.35%Nebraska641.03%Nevada350.56%New Hampshire310.50%New Jersey2283.68%New Mexico360.58%New York4156.69%North Carolina1993.21%North Dakota90.15%Ohio2924.71%Oklahoma701.13%Oregon911.47%Pennsylvania2654.27%Puerto Rico10.02%Rhode Island130.21%South Carolina1001.61%South Dakota170.27%Tennessee841.35%Texas5548.93%Utah891.43%Vermont220.35%Virgin Islands10.02%Virginia1973.18%Washington1572.53%West Virginia320.52%Wisconsin1121.81%Wyoming100.16%Other (please specify)330.53%Total6204100.00%Table SEQ Table \* ARABIC 20. Place of residence “Other (please specify)”In what state do you live? Other (please specify)1Active Duty Military in Spain2Active duty military living overseas3Alberta Canada, N = 34Armed Forces Europe5Brazil6Canada, N = 37Canada- Manitoba8Canada, Saskatchewan9Chad, Africa 10Doha Qatar11Indonesian12Italy (active duty spouse stationed oversees)13Live in Canada work in Michigan 14Manitoba Canada15Military - Ramstein air base 16Military overseas17Ontario18ontario canada19Ontario, Canada, N = 520Quebec, Canada21Saskatchewan, Canada, N = 222U.P. ,India 23UK, N = 2Analysis of Practice Analysis DataThe survey respondents were asked to rate the relative importance of the 21 tasks that are associated with the five (5) major practice domains and the frequency in which the tasks are performed. The average rating (M), standard deviation (SD), the lowest or minimum rating (Min), the highest or maximum rating (Max) and the most common rating (Mode) of the importance and frequency ratings are shown in Table 21 below. For each task, the number (frequency) and percentage of respondents selecting each point of the importance rating scale and frequency scales are shown in Tables 31 and 32 in Appendix D, respectively. For the importance ratings of the task statements, the average ratings ranged from 2.17 for Task 4.1 to 2.78 for Task 5.1. The SD is a statistic that indicates the range or dispersion of raw scores around the mean. For this data set, the SD ranged from 0.46 to 0.81. All tasks were rated as important or very important (i.e., an average rating of 2.17 or higher). For the frequency ratings of the task statements, the average rating ranged from 1.60 for Tasks 4.1 and 4.2 to 3.10 for Task 5.1. For this data set, the SD ranged from 0.92 to 1.44. No task received a mean frequency rating of “never” performed. The majority of tasks were rated as frequently performed. These mean importance and frequency ratings are more than sufficient to justify retention of all of the tasks in the draft test specifications. The importance and frequency rating scale data are presented in Table 21.After completing the importance and frequency ratings, survey respondents were presented with a question asking if they have any comments about the comprehensiveness and/or accuracy of the task statements, or if they believe there was a missing task statement. See Table 33 in Appendix E for comments about the task statements.Table SEQ Table \* ARABIC 21. Task Statements Importance and Frequency Ratings – Descriptive StatisticsTask Statements – Importance and Frequency RatingsDomains/TasksImportance, N = 6204Frequency, N = 6204MSDMinMaxModeMSDMinMaxModeDomain 1: Systematically perform ongoing and comprehensive quality and safety assessment and gap analysesTASK 1.1 Systematically assesses the organization institutional and environmental culture, patient experience and outcomes, leadership and teamwork by using a variety of methods (e.g., surveys, direct observation and/or environmental scans, adverse events, system errors, and near misses) to identify gaps in quality and safety.2.650.610332.761.31044TASK 1.2 Maintain current knowledge of national quality and safety standards and clinical guidelines from regulatory, accreditation, and specialty organizations, to promote ongoing change in practice to meet quality and safety indicators.2.760.480332.951.06043TASK 1.3 Evaluate quality and safety metrics by analyzing baseline and ongoing data to determine current state of performance, identify gaps, and identify opportunities for improvement.2.560.630332.431.35043Domain 2: Promote the integration of quality and safety practices within the organization at the governance and leadership levels.TASK 2.1 Incorporate quality and safety aims, tools, checklists and communication strategies into evidence-based projects to improve obstetric and neonatal care.2.670.560332.751.23044TASK 2.2 Foster team function by integrating leadership and teamwork skills that empower members of the clinical team and improve communication to achieve a climate of safety.2.720.520333.001.15044TASK 2.3 Educate and train obstetric and/or neonatal teams on quality and safety practices by conducting and debriefing team training exercises and implementing education using effective learning principles to improve task knowledge and optimize team functioning (e.g. mock codes, simulations).2.690.540332.301.18043TASK 2.4 Advocate for ongoing resource needs by serving as a liaison for quality and safety matters between clinicians and administrators (e.g., participating in meetings, serving on committees and through risk assessment activities) to improve care and outcomes.2.540.630332.361.29043TASK 2.5 Inform patients, colleagues, employers and the public about quality and safety initiatives/outcomes by disseminating outcome data, participating in benchmarking and publishing reports to maintain transparency.2.380.720331.931.40043Domain 3: Develop and implement quality and safety initiatives in obstetric and neonatal practice.TASK 3.1 Select and monitor key quality metrics that assess a balanced set of quality and safety domains indicative of organizational culture and benchmarking.2.360.730331.911.44043TASK 3.2 Apply recognized methods to improve quality and safety (e.g., model for improvement).2.540.600332.501.23043TASK 3.3 Design quality and safety initiatives in collaboration with necessary stakeholders to identify the target population, measures (e.g., structure, process, outcomes) and data collection approaches to address identified opportunities.2.330.740331.751.38040TASK 3.4 Promote quality and safety practices by using error prevention strategies and appropriate technology to facilitate improvement initiatives.2.590.600332.621.32044TASK 3.5 Integrate effective interventions into daily clinical workflow, using principles of high reliability, to guide practice and improve outcomes.2.620.570332.961.20044Domain 4: Evaluate and measure the effectiveness of quality and safety practices in obstetric and neonatal careTASK 4.1 Evaluate the implementation of quality improvement initiatives using relevant tools (e.g., fishbone, flow chart, run charts and control charts) to measure effectiveness of processes and outcomes.2.170.810321.601.40040TASK 4.2 Articulate the value of specific obstetric and neonatal quality initiatives by evaluating the balance between quality, outcome and cost, including the perspectives of all stakeholders (e.g., healthcare team, patients, and families).2.250.770331.601.42040TASK 4.3 Identify strategies of moving quality improvement initiatives into sustainment in order to maintain positive change in an overall obstetric and neonatal quality and safety program.2.420.680331.871.37043Domain 5: Professionalism and ethical practiceTASK 5.1 Demonstrate an ongoing commitment to lifelong learning and continued competence by keeping abreast of evidence-based practices related to quality and safety in order to optimize outcomes, improve system function, and reduce potential for harm.2.780.460333.100.92043TASK 5.2 Establish mechanisms to incorporate existing, updated, and new regulations related to quality and safety into obstetric and neonatal care to facilitate compliance with regulatory standards.2.550.610332.271.28043TASK 5.3 Ensure optimal disclosure of adverse events by developing and implementing standardized processes to promote transparency, patient trust, and risk mitigation.2.590.610332.181.41043TASK 5.4. Demonstrate professionalism by applying ethical principles (e.g., fairness, truthfulness, justice, beneficence, nonmaleficence, autonomy) relevant to patient safety and quality activities (e.g., RCA, disclosure) to maintain personal and institutional integrity and to foster a culture of safety and organizational excellence.2.730.500333.081.16044TASK 5.5 Provide support to patients, families and staff following an adverse event by implementing appropriate and standardized processes to minimize negative psychosocial consequences and mitigate risk.2.690.550332.421.30043As shown in Table 22, for each major domain, the survey respondents were asked to indicate the relative importance of each major domain in their practice of quality and safety. They were also asked to indicate the percentage of time spent performing tasks in each major domain. The average importance ratings for the major domains ranged from 2.51 for Domain 1 to 2.82 for Domain 5. The SD ranged from 0.43 to 0.65. As shown in Table 22, the number and percentage of respondents selecting each point of the importance rating scale indicate that more than half or the majority (i.e., from 59% to 83%) selected “Very Important” for the major domains As shown in Table 22, survey respondents were asked to indicate the percentage of time spent performing tasks in each of the 5 major domains of practice in their practice of quality and safety. The average (Mean) percentage of time ranged from 16.37% for Domain 1 to 31.54% for Domain 5. These mean importance ratings and average percentages of time spent are more than sufficient to justify retention of all of the domains in the draft test specifications.After completing the importance ratings and indicating the percentage of time spent performing tasks in each major domain of practice, survey respondents were presented with a question asking if they have any comments about the comprehensiveness and/or accuracy of the major domains of practice, or if they believe there was a missing a major domain of practice. See Table 34 in Appendix F for comments about the major domains of practice.Table SEQ Table \* ARABIC 22. Domains - Importance Ratings and Time SpentDomainImportanceTime Spent0123NMSDMSDNN%N%N%N%1591%2955%189235%320559%54512.510.6516.3712.1753602561%2575%174932%338962%54512.550.6317.1311.2453843311%1042%123023%408675%54512.720.5218.9512.0653844371%1362%145427%382470%54512.660.5617.0610.5253835110%521%86916%451983%54512.820.4331.5423.965430101.05Survey respondents were asked to indicate the criticality of the knowledge statements by applying the criticality rating scale (see Table 4 for the rating scale). Table 23 presents the number of respondents (N), the mean (M) rating, the SD for each knowledge statement. (See Table 35 in Appendix G for the count (N) and percentage (%) of respondents selecting each point of the rating scale.) The average ratings ranged from 1.42 for K-13 to 2.63 for K-11. The SD ranged from 0.58 to 0.95. The range of average ratings represents that survey respondents indicated that all knowledge statements were at a minimum somewhat critical or higher in terms of criticality. Therefore, these mean ratings are more than sufficient to justify retention of all of the knowledge statements as part of the content outline.After completing the criticality ratings of the knowledge areas, survey respondents were presented with a question asking if they have any comments about the comprehensiveness and/or accuracy of the knowledge statements, or if they believe there was a missing a knowledge statement. See Table 36 in Appendix H for comments about the knowledge statements.Table SEQ Table \* ARABIC 23. Knowledge Statements - Criticality RatingsKnowledge Statements – Descriptive StatisticsKnowledge StatementNMSDMINMAXMOD1Goals for health care quality improvement (e.g., STEEEP, IHI Triple aim)48701.830.920322Adverse events and event reporting (e.g., incident reports, near misses, root cause analyses)48822.440.690333Institutional quality and safety processes and priorities (e.g., peer review, Just Culture, credentialing, goals)48652.210.770324Design assessment strategies (e.g., defining the population, assembling teams, literature reviews, measure identification, patient/family perspective)48801.880.860325Assess and maintain appropriate organizational culture and safety assessment (i.e., systems focus, level of Just culture)48762.120.800326Terms and definitions/common critical language (e.g., quality, patient safety concepts, quality improvement, organizational culture/unit culture, patient experience of care/satisfaction/participation/co-production, systems thinking).48762.100.810327General quality and safety principles.48782.460.650338Awareness of legal/statutory and regulatory requirements, national quality and safety standards and clinical practice guidelines.48762.280.730339Defining and understanding quality terms and concepts, data and quality metrics, identifying gaps in quality and safety, including the use of benchmarking and risk adjustment48771.990.8103210Obstetric and neonatal resources for benchmarking best practice and outcomes48772.370.7103311Current professional standards and guidelines applicable to obstetric and neonatal care48092.630.5803312Current national, state, and regulatory standards and guidelines applicable to obstetric and neonatal care48032.550.6303313Methodologies of data display (e.g., run, control charts, pareto charts)47961.420.9303114The concept of value as a function of quality and cost47941.650.8703215How to implement and evaluate data collection strategies (e.g., checklists, process tools, huddle tools).48031.800.8903216Human factors engineering (i.e., design of systems and processes).48061.760.9103217Human psychology and cognition (e.g., situational awareness, violations of process/protocols, risk-taking, fear or repercussions, cognitive biases, attention and distractions, stress, burnout and fatigue).48042.190.7803218Safety climate, including safety briefings for staff, family involvement councils, quality and safety committees.48052.330.7303319Collaboration and effective communication strategies (i.e., handoffs, SBAR CUSS, debriefing, etc.)48032.490.6703320Understands next steps in advocating for system change when structured communications tools fail (e.g., chain of command; clinical escalation processes).47982.280.7303321Leadership skills (i.e., self-awareness/management; mentoring/sustainability/succession and transition planning; communication and conflict management).47522.340.7303322Teamwork concepts (i.e., team development, structure and function, diversity and inclusivity; collaboration, mutual respect, information diffusion; team meetings; code of conduct).47472.540.6503323Principles of teamwork and behaviors of effective teams47462.490.6703324Effective learning/teaching principles47362.370.6903325Use and principles of simulation, including unit drills involving simulated emergencies.47422.350.7303326Methods for determining human resource needs (e.g., hours per patient day, work hours per unit of service, work hours per birth, clinician to patient ratio, standards for staffing).47482.010.9003227Process for escalating concerns about resource needs.47332.160.7903228Issues that impact the work environment (e.g., the electronic medical record, medical devices, alarm fatigue, distractions, interruptions, overcrowding, noise, lighting, ergonomics of procedures, patient census and acuity).47462.320.7403329Dangers of workarounds.47402.300.7703330Relevant aspects of structural design standards.47371.750.9003231Understand next step in advocating for system change when structured communications tools fail (e.g., chain of command, clinical escalation processes).46892.160.7603232Various methods for disseminating quality and safety data to various stakeholders (e.g., annual reports, presentations, publications, public reporting, including websites, social media, and other media)46881.650.9203233Share data on key quality indicators with colleagues/organizations to improve transparency46861.880.8603234Prioritizing the importance of individual opportunities for improvement46882.040.8003235The importance of balancing measures46781.790.8603236The difference between structural, process, and outcome measures46741.670.8903237Process to develop goal statements for the metrics chosen46631.620.9103238Similarities and differences between quality and safety improvement methods (e.g., PDSA/PDCA, Improve, Six Sigma, Lean, CUSP).46801.510.9503139Team formation and dynamics (patient/family perspective, influencer model)46911.980.8703240Evaluate and review various types of evidence related the quality and safety initiative and application to the population and setting.46791.990.8303241Improvement process design (setting goals, benchmarks, thresholds and implementation plans)46301.890.8503242Select, collect, track, and monitor appropriate measures/indicators (e.g., analysis, data definitions, visualization and interpretation) with consideration of reliability, validity and bias.46251.810.8903243Medication, human milk, blood products, and nutritional safety (e.g., barcodes, e-prescribing, five rights of medication, EHR/ CPOE alarms and alerts).46292.480.7003344Risk reduction strategies (e.g. bundles, clinical pathways, quality guidelines)46252.320.7503345Error prevention strategies, (e.g., bundles, clinical pathways, quality guidelines).46222.430.7003346Auditing practices (e.g., feedback, surveillance).46211.950.8103247How to display and interpret data (e.g., run charts, control charts, score cards)46241.590.9303148Evaluation of outcomes and performance improvement46252.080.8003249The role of technology in quality improvement46231.950.8203250Define the value proposition in healthcare.46131.630.9403251Evaluate patient/family experience.46182.290.7803352Distinguish between cost and value in healthcare.46161.810.8703253Identification of waste in healthcare.46061.920.8503254Cost (monetary and non-monetary).46051.830.8703255Change theory.46001.700.9103256How to implement and maintain a communication strategy that involves all stakeholders.46042.020.8603257Recognition of threats to implementation and sustainability (e.g., fatigue, knowledge degradation, lack of upper level support/commitment, lack of team integrity, lack of personnel, competing priorities, lack of resources, disruptive behaviors, hierarchical professional behaviors).46132.280.7703358Steps in project sustainment (celebration of success, modification of data collection and review).46041.890.8703259Discern the relative strength of the design, source and methodology of new evidence and critical appraise the findings for use in practice (e.g., randomized trials, meta-analysis, expert opinion, observational studies, consensus documents).46061.740.9003260Evaluate changes in key Federal statutes and regulations governing patient safety and quality that impact practice and guidelines.45981.890.8703261The types of patient and provider protections that are regulated by respective states? statutes and regulations.45801.820.8803262How variations in state law can have an impact on quality and safety activities.45731.830.8803263Identify the elements of effective disclosure (e.g., disclosure of all harmful errors, explanation as to why error occurred, how effects will be minimized, steps to prevent recurrences, apology, acknowledgement of responsibility).45772.050.8203264Distinguish between system error and human error identifying at risk and reckless behavior and respond differently/appropriately to each balancing no blame with accountability45742.230.7703265Awareness of the differences between quality improvement projects and research.45721.760.9003266Human subject protections related to quality and safety45721.920.9103267Understand psychological harm experienced by the patient and second victims.45702.060.8603268Understand the concept of the second victim.45641.920.89032Finalization of the Content Outline On October 15, 2018, a meeting was held with the practice analysis committee to review the results of the practice analysis survey, and review and finalize the content outline and test specifications based on the results. See Appendix I for the agenda for the meeting. At the meeting, the committee was provided with:An overview of the purpose of the meeting and a brief overview of the work performed since the onset of practice analysis study.A presentation of the survey response and completion rates.A presentation of the demographic and background data.An overview on how to use the validity rating data and the qualitative data (i.e., survey respondents’ comments) from the study to finalize the content outline and test specifications.Guidance on how to identify decision rules concerning the validity rating data that they may use to finalize the content outline and test specifications. After reviewing the demographic and background questions (i.e., Tables 8 through 20 of this report), it was the consensus of the committee that the survey respondent group appeared to be representative of the population. Based on a review of the summary data for the importance and frequency ratings of the task statements (Appendix D), the committee initially decided to retain all task statements that had average mean importance ratings of 2.0 or higher, as that indicated that the tasks were rated as “Important” (2) or higher on the importance rating scale, and had a mean frequency rating of 1.0 or higher, as that indicated that the task was at least performed annually. The committee made the same conclusion about the major domains, as the domains were rated important or very important, and practitioners’ spent time performing tasks associated with the five domains. The committee initially decided to retain all knowledge statements that had a mean criticality rating of 1 or higher as that indicated that the knowledge statement was at a minimum “somewhat critical.” All knowledge statements were retained as a result of applying this decision rule.After reviewing the survey respondents’ comments about the comprehensiveness of the practice analysis, the committee made the following changes to the content outline. The majority of the changes were made to address redundant task and knowledge statements. Below are the changes made to the content outline:Domain 2 was revised because the committee indicated that the promotion of integration of quality and safety practices should not be limited to governance and leadership levels. This change was made after reviewing survey respondents’ comments. Below is the original domain followed by the revised version of the domain:Domain 2: Promote the integration of quality and safety practices within the organization at the governance and leadership levelsRevised: Domain 2: Promote the integration of quality and safety practices within the organization Task 3.2 was removed and consolidated with Task 3.3, as it was redundant to Task 3.3. The committee added examples of stakeholders to clarify what was meant by stakeholders. Below are the original tasks. Following the original tasks is the revised version of Task 3.3.Task 3.2 Apply recognized methods to improve quality and safety (e.g., model for improvement).Task 3.3. Design quality and safety initiatives in collaboration with necessary stakeholders to identify the target population, measures (e.g., structure, process, outcomes) and data collection approaches to address identified opportunities.Revised: Task 3.3 Apply recognized methods to design quality and safety initiatives in collaboration with necessary stakeholders (e.g., healthcare team, patients, and families) to identify the target population, measures (e.g., structure, process, outcomes) and data collection approaches to address identified opportunities.Task 3.4 was removed and consolidated with Task 3.5 because it was redundant to Task 3.5. Below are the original tasks. Following the original tasks is the revised version of Task 3.5.Task 3.4 Promote quality and safety practices by using error prevention strategies and appropriate technology to facilitate improvement initiatives.Task 3.5 Integrate effective interventions into daily clinical workflow, using principles of high reliability, to guide practice and improve outcomes.Revised: Task 3.5 Integrate quality and safety practices into daily clinical workflow by using error prevention strategies, appropriate technology, and principles of high reliability to guide practice and improve outcomes. Task 5.2 was removed from Domain 5, as it was redundant to Task 1.2. Below are the original tasks. Task 1.2 Maintain current knowledge of national quality and safety standards and clinical guidelines from regulatory, accreditation, and specialty organizations, to promote ongoing change in practice to meet quality and safety indicators.Task 5.2 Establish mechanisms to incorporate existing, updated, and new regulations related to quality and safety into obstetric and neonatal care to facilitate compliance with regulatory standards. Knowledge Statements:The following knowledge statements were deleted because they were redundant to K-8, K-11 and K-12. K-60 Evaluate changes in key Federal statutes and regulations governing patient safety and quality that impact practice and guidelines.K-61 The types of patient and provider protections that are regulated by respective states’ statutes and regulations.K-62 How variations in state law can have an impact on quality and safety activities.Knowledge statement “K-68 Understand the concept of the second victim” was removed as it was redundant to K-67 Understand the psychological harm experienced by the patient and second victims. The following knowledge statement was added:Knowledge of ethical principles as they apply to patients, families, providers, and organizations. The committee added the knowledge statement indicated above as ethical practice was part of the domains and tasks, and they indicated that there should be a knowledge statement associated with the tasks.See Appendix J for the final content outline.Finalization of the Test WeightsTo derive preliminary test weights, a multiplicative model was used to combine the data collected from the study. Three different sets of preliminary test weights were produced for review and consideration by the committee. As shown in Table 24, the first set (i.e., #1) was based on the importance and percentage of time estimates for the major domains, the second set (#2) was based on the respondents’ percentage weights for the domains, and the third set (#3) was based on the combination of sets #1 and #2. All weights for the tasks were based on the importance and frequency ratings.For set #1, to derive the preliminary test weights, the importance and percentage of time estimates were combined to produce weights for the domains. The sums of each of these data were totaled, and dividing the sum of the domain by the total, derived the percentage weight for each domain. To derive the preliminary number of test questions by domain, the total number of test questions (i.e., 100) was multiplied by the domain weight. To derive the preliminary number of test questions by task statement within a domain, the importance and frequency ratings were combined (i.e., multiplied) to produce weights for the task statements. The task weights were summed within the domain, and then each task weight was divided by the sum, and then multiplied by the domain weight. To derive the preliminary number of test questions by task statement, the total number of test questions on the examination (i.e., 100) was multiplied by the task statement weight. For set #2, to derive the preliminary test weights, the survey respondents’ mean percentages for the domains (see Table 25 for the survey respondents’ mean weights) were used as the weights for the domains. To derive the preliminary number of test questions by domain, the total number of test questions on the examination (i.e., 100) was multiplied by the domain weight. The weights for the task statements were derived using the same procedure used to derive weights for set #1.For set #3, averaging the domain weights of sets #1 and #2 were used to derive the domain weights. The weights for the task statements were derived using the same procedure used to derive weights for set #1.Table SEQ Table \* ARABIC 24. Three Sets of Preliminary Test SpecificationsDomains/Tasks#1: Preliminary Test Specifications Using Validity Rating Data#2: Preliminary Test Specifications Using Survey Respondents’ Domain Percentages & Task Validity Ratings#3: Preliminary Test Specifications Based on an Average of #1 and #2 Domain WeightsWeights from Validity Ratings% of Items# of ItemsDomain Weights from Respondents% of Items# of ItemsAverage Weights% of Items# of ItemsDomain 115.2015.20%1517.6617.66%1816.43%16.4317TASK 1.1 7.315.13%57.316.0%67.315.54%6TASK 1.2 8.135.70%68.136.6%78.136.17%6TASK 1.3 6.224.36%46.225.1%56.224.72%5Domain 216.1616.16%?16?17.5617.56%?18?16.8616.68%?16?TASK 2.1 7.353.68%47.353.99%47.353.83%4TASK 2.2 8.174.08%48.174.44%48.174.26%4TASK 2.3 6.203.10%36.203.37%36.203.23%3TASK 2.4 6.013.00%36.013.26%36.013.13%3TASK 2.5.4.612.30%24.612.50%34.612.40%2Domain 319.0419.04%?19?20.9620.96%?21?20.0020.00%?20?TASK 3.1 4.502.91%34.503.20%34.503.05%3TASK 3.2 6.364.11%46.364.52%46.364.32%4TASK 3.3 4.082.64%34.082.90%34.082.77%3TASK 3.4 6.794.38%46.794.83%56.794.61%5TASK 3.5.7.765.01%57.765.51%67.765.26%5Domain 416.7816.78%?17?19.4719.47%?19?18.1318.13%?18?TASK 4.1 3.475.02%53.475.83%53.475.42%5TASK 4.2 3.615.23%53.616.06%63.615.65%6TASK 4.3 4.526.53%74.527.58%84.527.06%7Domain 532.8132.81%?33?24.8624.86%?25?28.8428.84%?29?TASK 5.1 8.618.08%88.616.12%68.617.10%7TASK 5.2 5.785.43%65.784.11%45.784.77%5TASK 5.3 5.655.30%55.654.01%45.654.66%5TASK 5.4. 8.427.90%88.425.99%68.426.95%7TASK 5.5 6.506.10%66.504.63%56.505.36%5Total?100.00%100?100.00%?100?100.00%?100Table SEQ Table \* ARABIC 25. Survey Respondents' Mean Percentage of Test Questions Per DomainDomainWeights from Survey RespondentsDomain 1: Systematically perform ongoing and comprehensive quality and safety assessment and gap analyses17.66%Domain 2: Promote the integration of quality and safety practices within the organization17.56%Domain 3: Develop and implement quality and safety initiatives in obstetric and neonatal practice20.96%Domain 4: Evaluate and measure the effectiveness of quality and safety practices in obstetric and neonatal care19.47%Domain 5: Professionalism and ethical practice24.86%Total100.51%The committee reviewed the three (3) sets of preliminary test weights and decided to use set #2 as the starting point for finalizing the test weights. They selected set #2 because it had the lowest weight for Domain 5, as they decided that the weight for Domain 5 should be lowered due to the reasons described below.When finalizing the test specifications, in addition to using the results of the job analysis study in making decisions about the test specifications, the committee was advised to take into consideration the practical aspect of test development, as the scope and depth of the subject matter should be taken into consideration when finalizing the test weights. For example, some tasks, although rated high in terms of importance and frequency may be limited in scope, or conversely some tasks may have been rated high in importance but may not be frequently performed, yet may have more breadth and depth of subject matter than a task that is important and is frequently performed. Therefore, the committee may consider adjusting the weights given these considerations. Based on a review of the data, consideration of the scope and depth of content, and in consideration of the revisions to some of the tasks (i.e., removal of redundant statements) as described in the previous section, the committee decided to adjust the weights by first reviewing the weights associated with Domain 5 – Professionalism and Ethical Practice as follows:Domain 5: Although Domain 5 – Professionalism and Ethical Practice and its associated tasks are important for the practice of quality and safety, having a weight of approximately 25% (i.e., 24.86%) of the total exam would present a challenge for item and test development given that some of the tasks in Domain 5 are related or redundant to tasks in other domains. Therefore, they adjusted the weight of Domain 5 from 24.86% to 10.02%. As described previously, Task 5.2 was removed from Domain 5 because it is redundant to Task 1.2. In addition, the committee decided that Task 5.1 (“Demonstrate an ongoing commitment to lifelong learning and continued competence by keeping abreast of evidence-based practices related to quality and safety in order to optimize outcomes, improve system function, and reduce potential for harm.”) would not be included as part of the test specifications for the written examination because this task will be addressed as a recertification requirement. Therefore, the weights associated with Task 5.1 (6.12%) and Task 5.2 (4.11%) were redistributed among other tasks in other domains as described below. Of the remaining 3 tasks associated with Domain 5, the weights for Tasks 5.3 (i.e., 4.01%) and Task 5.5 (i.e., 4.63%) were combined and adjusted from approximately 8 questions to 6 questions. The weight for Task 5.4 was adjusted from 5.99% or 6 questions to 4 questions. The reasons for these adjustments is that the committee believed that the adjustments would better reflect the relative importance of the tasks. The removal of 5.1 and 5.2 from Domain 5 and the reduction of weights for Tasks 5.3, 5.4, and 5.5 resulted in redistributing 14 to 15 items (i.e., 14.84%) depending on how the weight is rounded to other areas of the test specifications as described below.Domain 1: The committee increased the weight of Domain 1 from 18 items to 21 items, and the 3 items were distributed among the 3 tasks, thereby, increasing each task’s test weight by 1 item and maintaining the same relative weightings of the tasks (i.e., from 6, 7, and 5 items for Tasks 1.1, 1.2, and 1.3 to 7, 8 and 6 items respectively). Domain 2: The committee increased the weight of Domain 2 from 18 to 21 items, and made the following adjustments to the task statement weights: Task 4.1 was reduced from 4 to 3 questions, Task 2.2 was increased from 4 to 5 questions, Task 2.3 was increased from 3 to 4 questions, Task 2.4 was increased from 3 to 6 questions, and there was no adjustment made to Task 2.5. The reasons for these adjustments is that the committee believed that the adjustments would better reflect the relative importance of the tasks. Domain 3: The committee increased the weight of Domain 3 from 21 to 25 items, and made the following adjustments to the task weights: Task 3.1 was increased from 3 to 4 questions, the weights for Tasks 3.2 and 3.3 (as indicated in the previous section, 3.2 was removed and combined with 3.3.) were combined to have 8 questions for Task 3.3., and the weights for Tasks 3.4 and 3.5 (as indicated in the previous section, 3.4 was removed and combined with 3.5) were combined to have 13 questions allocated to Task 3.5. The reasons for these adjustments is that the committee believed that the adjustments would better reflect the relative importance of the tasks. Domain 4: The committee increased the weight of Domain 4 from 19 to 23 items, and made the following adjustments to the task weights: Task 4.1 was increased from 6 to 7 questions, Task 4.2 was increased from 6 to 7 questions, and Task 4.3 was increased from 8 to 9 questions. The same relative weightings of the tasks were maintained with these adjustments. See Table 26 for the final test specifications.Table SEQ Table \* ARABIC 26. Final test specifications based on job (practice) analysis dataNCC Quality and Safety Sub-SpecialtyDOMAINS/TASKSFINAL Test SpecificationsDomain Weights from Respondents% of Items# of itemsDomain 1: Systematically perform ongoing and comprehensive quality and safety assessment and gap analyses21.0021.00%21TASK 1.1 Systematically assesses the organization institutional and environmental culture, patient experience and outcomes, leadership and teamwork by using a variety of methods (e.g., surveys, direct observation and/or environmental scans, adverse events, system errors, and near misses) to identify gaps in quality and safety. 0.347.1%7TASK 1.2 Maintain current knowledge of national quality and safety standards and clinical guidelines from regulatory, accreditation, and specialty organizations, to promote ongoing change in practice to meet quality and safety indicators.0.387.9%8TASK 1.3 Evaluate quality and safety metrics by analyzing baseline and ongoing data to determine current state of performance, identify gaps, and identify opportunities for improvement.0.296.0%6Domain 2: Promote the integration of quality and safety practices within the organization.?20.8920.89%??21TASK 2.1 Incorporate quality and safety aims, tools, checklists and communication strategies into evidence-based projects to improve obstetric and neonatal care.0.234.75%3TASK 2.2 Foster team function by integrating leadership and teamwork skills that empower members of the clinical team and improve communication to achieve a climate of safety.0.255.28%5TASK 2.3 Educate and train obstetric and/or neonatal teams on quality and safety practices by conducting and debriefing team training exercises and implementing education using effective learning principles to improve task knowledge and optimize team functioning (e.g. mock codes, simulations).0.194.00%4TASK 2.4 Advocate for ongoing resource needs by serving as a liaison for quality and safety matters between clinicians and administrators (e.g., participating in meetings, serving on committees and through risk assessment activities) to improve care and outcomes.0.193.88%6TASK 2.5 Inform patients, colleagues, employers and the public about quality and safety initiatives/outcomes by disseminating outcome data, participating in benchmarking and publishing reports to maintain transparency.0.142.98%3Domain 3: Develop and implement quality and safety initiatives in obstetric and neonatal practice?24.9424.94%?25?TASK 3.1 Select and monitor key quality metrics that assess a balanced set of quality and safety domains indicative of organizational culture and benchmarking.0.153.81%4TASK 3.2 Apply recognized methods to improve quality and safety (e.g., model for improvement).TASK 3.3 Apply recognized methods to design quality and safety initiatives in collaboration with necessary stakeholders (e.g., healthcare team, patients, and families) to identify the target population, measures (e.g., structure, process, outcomes) and data collection approaches to address identified opportunities.0.225.38%5+3=80.143.45%TASK 3.4 Promote quality and safety practices by using error prevention strategies and appropriate technology to facilitate improvement initiatives.TASK 3.5 Integrate quality and safety practices into daily clinical workflow by using error prevention strategies, appropriate technology, and principles of high reliability to guide practice and improve outcomes.0.235.74%6+7=130.266.56%Domain 4: Evaluate and measure the effectiveness of quality and safety practices in obstetric and neonatal care?23.1623.16%?23?TASK 4.1 Evaluate the implementation of quality improvement initiatives using relevant tools (e.g., fishbone, flow chart, run charts and control charts) to measure effectiveness of processes and outcomes.0.306.93%7TASK 4.2 Articulate the value of specific obstetric and neonatal quality initiatives by evaluating the balance between quality, outcome and cost, including the perspectives of all stakeholders (e.g., healthcare team, patients, and families).0.317.21%7TASK 4.3 Identify strategies of moving quality improvement initiatives into sustainment in order to maintain positive change in an overall obstetric and neonatal quality and safety program.0.399.02%9Domain 5: Professionalism and ethical practice?10.0210.02%?10TASK 5.3 Ensure optimal disclosure of adverse events by developing and implementing standardized processes to promote transparency, patient trust, and risk mitigation. TASK 5.5 Provide support to patients, families and staff following an adverse event by implementing appropriate and standardized processes to minimize negative psychosocial consequences and mitigate risk. 0.595.94%6TASK 5.4. Demonstrate professionalism by applying ethical principles (e.g., fairness, truthfulness, justice, beneficence, nonmaleficence, autonomy) relevant to patient safety and quality activities (e.g., RCA, disclosure) to maintain personal and institutional integrity and to foster a culture of safety and organizational excellence. 0.404.08%4Total?100.00%?100Survey Respondents’ Opinion about Eligibility and Continuing Education RequirementsSurvey respondents were asked to indicate the minimum eligibility requirement to take the examination that would be necessary to achieve competence in quality and safety specialty practice. Of the 4,536 respondents to this question, 4,129, or 91.03%% of the respondents selected “Currently licensed in the US and Canada” and 8.97% indicated “Other (please specify).” See Appendix K for survey respondents’ reasons as to why they didn’t agree with the eligibility requirements. Table SEQ Table \* ARABIC 27. Survey respondents’ opinion about eligibility requirementsWhich of the following minimum eligibility requirements to take this examination would be necessary to achieve competence in quality and safety specialty practice?ResponseN%Currently licensed in the US or Canada412991.03%Other (please specify)4078.97%Total4536100.00%Survey respondents were asked to indicate the continuing education requirement to maintain the credential that would be necessary to achieve competence in quality and safety specialty practice. Of the 4,518 respondents to this question, 4,231, or 93.65%% of the respondents selected “15 CEs every three years specific to quality and safety” and 6.35% indicated “Other (please specify).” See Appendix L for survey respondents’ reasons as to why they didn’t agree with the eligibility requirements. Table SEQ Table \* ARABIC 28. Survey respondents’ opinion about continuing education requirementsWhich of the following continuing education requirements to maintain the credential would be necessary to achieve competence in quality and safety specialty practice?ResponseN%15 CEs every three years specific to quality and safety423193.65%Other (please specify)2876.35%Total4518100.00%Interest in the CredentialSurvey respondents were asked to indicate the likelihood of seeking the credential and 44.73% indicated that they would be likely or very likely to seek the credential, 33.25% indicated that they would be somewhat likely and 22.02% indicated that they would be not likely to seek the credential. See Table 29 for these data. If survey respondents selected “Not Likely” they were asked to provide a reason in response to an open-ended question. See Appendix M for responses to this question. Table SEQ Table \* ARABIC 29. Interest in seeking the credentialHow likely would you be interested in seeking this credential?LikelihoodN%Not Likely100122.02%Somewhat Likely151133.25%Likely102722.60%Very Likely100622.13%Total4545100.00%Survey respondents were asked how the credential would of benefit and they were presented with options in which they were asked to select all that apply. As shown in Table 30, the majority of the respondents to this question indicated that professional development and recognition in the specialty of quality and safety would be a benefit of the credential. For responses to “Other (please specify), please see Appendix M.Table SEQ Table \* ARABIC 30. Benefits of the credentialHow will this credential benefit you? (Select all that apply.)CountProfessional development3737Provides recognition in the specialty of quality and safety3357Will increase my salary407Enable new job opportunities1063Encouraged by my employer755Other (please specify)285Summary and RecommendationsUsing practice analysis data as a basis for developing a content outline and test specifications will contribute to the validity of the examination. As described in this report, the practice analysis data were used to validate the contents of the draft content outline and draft test specifications and produce preliminary test weights by major domain and task statement. For the knowledge statements, the practice analysis also produced validity data that may be used for item development purposes. The committee used the data from the practice analysis study to finalize the test specifications and content outline for the examination program. Appendix SEQ Appendix \* ALPHABETIC A. Psychometrician's qualificationsDr. Freilicher has a Ph.D. in Measurement and Evaluation from Columbia University. Her doctoral dissertation was on passing point methodology (i.e., Freilicher, T.M. (2005). A comparison study of standard setting methods using test score data for a medical competency simulation examination (Doctoral dissertation, Columbia University, 2005). ProQuest Information and Learning Company, UMI Number 3159737). She has more than 30 years of experience developing certification, licensure, and employee selection examination programs for a variety of domestic and international professional organizations and/or regulatory agencies. She has extensive experience conducting job analyses, developing competency frameworks, test specifications, item and exam development, and standard setting. Dr. Freilicher has managed the development and implementation of high-stakes and large-scale exam programs. She assists certifying bodies to ensure that examination programs meet testing industry and/or accreditation standards (e.g., APA, EEOC, ANSI, NCCA).Appendix SEQ Appendix \* ALPHABETIC B. Agenda for job analysis meetingNational Certification Corporation (NCC)Quality and Safety Sub-Specialty Certification Examination Job Analysis MeetingFebruary 8-9, 2018AGENDAThursday, February 8, 20189:00 – 9:15 amWelcome and introductions9:15 - 9:30 amOverview of the job analysis studyThe purpose for conducting the job analysis.What is a job analysis and the conduct of a job analysis study.The role of the committee and timeline of activities.9:30 – 10:00 amOverview of the structure of a job analysisWhat does a major domain of practice represent?What is a task?What is a knowledge statement?10:00 – 10:15 amBreak10:15 - 12:00 pmDeveloping the job analysisThe committee will review the draft job analysis to identify the major domains for the scope of practice.12:00 - 1:00 pmLunch1:00 – 1:15 pmDevelopment of task statements for the domains of practiceOverview of how to develop and structure task statements.1:15 – 3:00 pmDevelopment of task statements for the domains of practiceThe committee will break into small groups and each group will draft task statements for a subset of the major domains of practice. 3:00 – 3:15 pmBreak3:00 – 3:30 pmDevelopment of task statements for the domains of practice, continuedIf necessary, the small groups will draft task statements for a subset of the major domains of practice. 3:30 – 5:00 pmReview draft task statementsThe full group will reconvene to review and refine the work completed by the small groups.5:00 pmMeeting adjourns for the dayFriday, February 9, 20189:00 - 10:00 amOverview of today’s activities/Review of task statementsIf necessary, the full group will reconvene to complete their review and refinement of the work completed by the small groups.10:00 - 10:15 amBreak10:15 – 10:30 amOverview of how to develop knowledge statements10:30 – 11:30 amDevelopment of knowledge statementsThe committee will break into small groups to identify knowledge statements associated with the task statements.11:30 – 12:00 pmReview of knowledge statementsThe full group will reconvene to review and refine the work completed by the small groups.12:00 - 1:00 pmLunch1:00 – 1:30 pmReview of knowledge statements, continuedIf necessary, the full group will reconvene to review and refine the work completed by the small groups.1:30 – 1:45 pmJob analysis rating scalesThe committee will be oriented to the types of ratings scales typically used for job analysis surveys.Review of the ratings scales to be used for the job analysis survey.1:45 – 2:30 pmDemographic and background questions for the survey Review of demographic and background questions to be used for the job analysis survey. 2:30 – 3:00 pmNext stepsDiscuss the dissemination of the survey and pilot testing.Review of pilot results.3:00 pmMeeting adjournsAppendix SEQ Appendix \* ALPHABETIC C. Demographic/background questions: verbatim responses to “Other, please specify” optionTable 7. Primary Role: Verbatim Responses to “Other Roles” What is your primary role (i.e., where you spend the majority of your time)? “OTHER ROLES” VERBATIM RESPONSES130% clinical, 70% management250 % clinical practice, 50% leadership/administrative 350 clinical/ 50 admin450/50 administrative and direct care/charge nurse 550/50 clinical practice and administrative 650% clinical and 50% administrative750% clinical; 50% nursing leadership8Admin and clinical practice split. Also I'm an assistant manager that just wasn't a choice9Administrative & Clinical 10Adminstrative/Clinical Practice 50/5011admission assessment, review of charge entry12All of the above13An equal balance of administration, clinical care and education14Assistant manager, some patient care, education, administrative 15Assistant nurse manager 16Attending the Births , Assistant in Obstetrics procedures , Provide Child birth Education & 17Bedside/education and administration18Bereavement Coordinator, RN 19BSN 20Care coordination21Case management 22case management activities23Case Management/LTC Coordinator24case review25Central Line Resource Nurse Team26Chairman/MFM/practice27Chart review, abstractions, & physician education of new or updated core measure & evidence based practice 28Chart review/ regulatory compliance 29Chart reviews 30clincal practice leader31clinical analyst, documentation development and techincal support32Clinical and Administration 50/5033clinical and leadership- assistant clinical manager34Clinical chart review35clinical coordinator36Clinical Education37clinical educator of maternity in patient unit38Clinical Nurse Supervisor39Clinical practice and Education coordinator40Clinical practice and QA41Clinical Practice Coordinator - policies, orientation, staff education42Clinical practice half time, educator half time43Clinical practice, education, process improvement and safety44Clinical quality review45Clinical Quality Specialist46Clinical review/DC Planning47Clinically48Collecting and analyzing quality data49Combination of admin and clinical 50combination of administrative and education51Combination of clinical practice, educator and administrator52combonation clinical and quality53Consultancy including plan/design/testing/facilitating trainings and workshops54Coordinating staffing & payroll55CQI56data analysis57data collection58data collection, management role, support clinical staff59day to day operations, education, administrative, 60discharge planning61EBP, QUALITY62Educating community hospitals of all levels of care63Education and Quality64education, practice support ,chart review65Education, risk, safety and quality, simulation66Educator plus 44 hours of clinical practice per month (faculty practice) inpatient and outpatient67Educator, auditor, consultation, competencies, policy writing, emergency drills68Educator/clinical resource/ policy 69Electronic health record configuration70End user support, education, delivery stats71Essential Oil practice, education, implemtation72Evaluated Clinical Practice, implement EVB, research73Evidence-based practice resource, case analysis, perinatal education74faculty75Faculty for OB/GYN residency76Guidelines/Policy/Regulatory issues/Corrective Actions/Educational presentations/Research77half administrative, half clinical78Half clinical half administrative 79High Risk Perinatal Program Coordinator80Hospital81Hospital Quality82Hospital, bedside nursing 83I am both an academic administrator and professor84I am the clinical coordinator and also staff as an RN in Nursery, Labor and Delivery and Post Partum85I frequently step into staffing when census requires86I split my time 50/50 between roles87I split time between clinical practice, childbirth educator and OB clinical nursing instructor88I'm about 50/50 with clinical and administrative 89IBCLC90IBCLC, CCE, NRP Coordinator, BFUSA Administrator91Im a nursing supervisor- I charge in the unit and work in the office as well92Infection Control93International maternal health program development94L&D Baby nurse, Transport nurse for NICU, ECMO specilist, resourse nurse for NICU95Labor and delivery 96Labor and delivery nurse97Labor nurse at bedside 98Laboratory support to post partum hemorrhage cases99Lactation Consultant 100Lactation Consultant 101LC and teach breastfeeding class to new parents102management103Manager of inpatient nursing unit104maternity case management105Mix of education and clinical practice and administration106National Director of Quality for Women‰??s and Children‰??s Services 107Neo/Peds Respiratory manager108Neonatal and Pediatric Critical Care Transport team includes high risk maternal transports109Neonatal Hospitalist110nicu quality111NICU respiratory therapist 112NICU RN staff clinical educator 113NICU staff nurse114NICU staffing115Nok8ds116Nurse117nurse navigator118nurse navigator / family education and support admission to discharge119OB Education/Early Detection &Prevention/ High Risk Management 120Ob Hospitalist121Obstetric parinet safety officer, employed by risk management; soon to return to clinical practice122Obstetrical Clinical Outcomes Assessment Program; data abstraction123Operations 124Orientation, Policy, QI work125Outcome management, professional practice, policy and procedure development and improvement. 126Outcomes127Parent Education & Palliative Care128Patient care129Patient care130Patient Care Coordinator and charge in Level III NICU.131Patient rounding as nurse leader, follow up calls to patients, tour classes132Perinatal and neonatal Patient navigation 133Perinatal nurse navigator 134Perinatal Outreach Coordinator 135Perinatal Quality and Safety136Perinatal safety specialist137Perinatal units/MD-RN training ordersets138Perinatology139Policy/practice integration140Postpartum and Nursery Nursing141Practice (Performance) Improvement142Precept143Pt communication/consults144Pt education 145Pt Flow Supervisor, supportive of Charge Nurse, reports to Nurse Manager146QAPI147QI148RCP III149relief charge /team lead150Research and clinical specialist support equally151resource nurse152RN153RN154RN155RN156RN providing bedside care in NICU157safety, quality, and clinical care158scn nurse159Second OB nurse for delivery 160Some clinical, mostly collecting data, policies, education, community outreach, EBP, etc.161Staff nurse and employee education162Staff nurse labor &delivery unit163staff RN in charge of patien engagement164Staff RN in labor and delivery165Staff RN on Maternity unit166staff support/clinical adviser for patients in L&D (60+bed unit), educator167staff/charge nurse168Staffing, ensuring proper care, responding to emergencies, patient placement169Supervision, some clinical, some teaching 170Supervisor/ Quality Improvement and Regulatory171Supervisor/charge nurse172Supervisor/educator173Surveying, building survey processes174Teaching NRP, problem solving issues with Healthstream for our system.175Technical support and education176Transport177Transport and discharge coordination 178Transport of Neonatal patients to NICU179triage coordinator (Charge nurse for 3 floors)180Variety of subroles 181Vascular access nurse182Womens/Childrens is one of my regulatory coverage areas for RPI183Wx1QUALITY (5 responses)2Quality and chart review3Quality and education4quality and outcomes management5Quality and patient safety (2 responses)6Quality improvement (3 responses)7Quality improvement coordinator8Quality improvement, education9Quality oversight10Quality Review (2 responses)11Quality review, education12Quality, Education, Policies, Process Evalution 13Quality, Safety, Policies and Procedures, Evidence-Based Practice, Project Implementation14Quality/RiskTable 8. Practice Setting: Verbatim Responses to “Other (please specify)” Table 8. Which of the following best describes your practice setting? OTHER (PLEASE SPECIFY) VERBATIM RESPONSES160% clinical and 40% academic2Academic health center3Academic high risk OB Practice 4Academic medical center, N =25air nedical6Air transport. I see all settings7Ambulatory clinic8ambulatory setting9Birthing center in hospital 10Both community health center and hospital11both hospital and academic setting12Both outpatient clinic and hospital13Clinic 14Clinic associated with major hospital 15College16Combined inpatient, outpatient and teaching role for residents and medical students17Community clinic within a hospital 18Community College/Community Hospital19Community hospital20Corporate office21Crisis Care Center22Critical Care Neonatal/ Pediatric Transport Team23Critical Care Transport, N = 324D25Data collection / management; Quality improvement projects26Department of Health27Fbc 28Flight29H30health system31health system health plan32Health System that own 72 hospitals33Health system with responsibility across the continuum34helicopter transport35Helicopter transport36Hi 37High risk OB transport38Hmo39Home care, N = 240homecare41Hospital & academic setting42Hospital and Academic 43Hospital and Clinic setting 44Hospital and hospital owned clinic45Hospital based clinic, N = 346Hospital based practice47Hospital mainly, office-based practices48Hospital outpatient clinic49hospital owned employed clinical care50Hospital System, N = 251Hospital system of 7252Hospital within a research diagnostic setting53hospital,ambulance, fixed wing54I staff Triage in the hospital and a private practice55I teach clinical in a hospital and also teach RN nursing theory at a community college.56I work 20hr/wk in hospital setting,NICU and 20 hr/wk in outpt clinic clinic57??58Informatics59Insurance60Integrated care delivery system61Interfacility62International NGO63Large multi hospital system64Law firm65Maternal fetal medicine department66Maternal Fetal Medicine in Hospital based outpatient setting67Medical training group68MFM Clinic69Military clinic70Military treatment 71Mission hospital in Chad, Africa 72Mixed all of the above73Mixed Hospital AND freestanding Birth Center74Most midwives have a combination of a clinic and hospital and their primary setting 75Multi- Systems Quality Collaborative76Multiple hospital system77Multiple Hospitals78Multiple locations across the US--some are hospitals, academic setting, etc79My clinical setting is 1/2 hospital-owned community clinic and 1/2 inpatient care on the L&D unit. Full scope midwifery care80Nutrition (TPN & Enteral) software business81Outpatient clinic in hospital82Outpatient Maternal Fetal Testing83Outpatient maternal/fetal Medicene84Perinatal Center (Maternal Fetal Medicine)85Perinatal Center (Network)86Perinatal consortium87Policy consultant88professional organization89Program development90Public Health/Government Hospital91Q92Regional93Saw94Several settings for e.g. hospital, community clinic, private practice and academic setting95single specialty practice - one office hospital based, the other community private practice96state Perinatal Quality Collaborative97System educator for ambulatory and inpatient settings98Teaching at multiple community hospitals99Teaching hospital100Transport, N = 8101Transport (air and ground) of Neonates and High Risk OB102Transportation 103University104V105We are a Neonatal Pediatric Critical Care transport team.106Women health clinic 107YTable 12. Highest level of education: Verbatim Responses to “Other (please specify)” Table 12. What is your highest level of education? OTHER (PLEASE SPECIFY) VERBATIM RESPONSES162 M32 classes shy of a MSN43 year diploma in nursing degree, N = 85ADN6ADN in Nursing, Bachelor of Arts Administration7ADN nursing, mS library Science8ADN-- registered nurse9ADN, graduate with BSN Summer 201910ASN with inpatient OB certification 11Associate and actively pursuing BSN12ASSOCIATE IN NURSING AND 2 YEARS OF MIDWIFERY13Associate in Nursing, BS in Biology14Associates, working toward BSN15Baccalaureate and Certificate for neonatal practitioner (before masters program initiated)16Baccalaureate and NNP Certificate and Board Certified17Baccalaureate plus multiple certifications for further study18Bachelor of Science in Education; Diploma in Nursing19Bachelor Science of Nursing 20BS Biology and BS Nursing21BS in Nursing + Certification in Nurse-Midwifery22BSN23Bsn24BSN and Certificate of Nursing Education 25BSN plus NNP training/certification.26BSN RNC-OB27BSN with certificate training28BSN working on Masters29BSN- enrolled in master's program- 1 more year.30BSN-OB-EFM31BSN, MSN in progress 12/2018 graduation32BSN, RNC-MNN, IBCLC33BSN, with Masters nearing completion34Certificate (Critical Care Paramedic)35Certificate 198036Certificate APRN, board certified NNP37Certificate degree38Certificate for NNP 39Certificate neonatal nurse practitioner40Certificate NNP41Certificate program42Certificate registered nurse and nurse practitioner 43Certificate trained - post baccalaureate 44Certification 45certification and associates46Certification and grandfathered 47Certification in midwifery in the UK48Certification Neonatal NP49Certified NCC50Completing DNP in Spring 201951Completing PhD in Nursing (in last course before Comprehensive exams)52Current Bachelors, working on a Masters in Nursing Education. Graduation Aug 201953Currently enrolled DNP NNP program54Currently enrolled in Master‰??s program 55currently enrolled in Masters education program56Currently enrolled in Masters program57currently enrolled in masters program for CNM58Currently in a DNP program59Currently in a masters program for midwifery60Currently in graduate school61Currently in masters program62Currently in Masters program for counseling63currently in Masters program for Patient Safety and Quality64Currently in MSN program. Expected graduation December 201965Currently in school completing BSN 66Currently in school to obtain my FNP masters prepared67currently obtaining BSN68Currently pursuing BSN69currently pursuing my Masters degree70Currently taking Masters level courses71D72Diploma, N = 2373Diploma 3year Nursing school74Diploma and certified75Diploma from Piedmont Hospital school of Nursing 76Diploma graduate from nursing school77diploma greaduate from nursing school78Diploma in Nurse Midwifery79Diploma in nursing, N = 4580Diploma in nursing, certificate NNP81Diploma in nursing, currently enrolled in an RN to BSN program82Diploma nurse from Deaconess School of Nursing83Diploma nurse with 2.5 year's towards BSN84diploma of nursing 198285diploma of nursing and 2 years at the University of Michigan86diploma of nursing,plus 2 years at the University of Michigan87diploma program (3yrs)/ certification in inpatient obstetrics88Diploma program nursing graduate89Diploma RN, N = 1390Diploma RN with RNC-OB cert.91Diploma RN, 6 credits shy of BSN92Diploma RN, but 2 semesters from recieving BSN93Diploma school of nursing 94Diploma with dual Respiratory Credentials95Diploma- RT96diploma--3 year school97Diploma-RN98Dipolma99DNP100Doctor of Nursing Science101Doctorate - Health Science102Doctorate EdD, N = 4103E-FM and IBCLC certification 104EdD105EdS106Finding masters in December & concurrently working on DNP107Finishing Master‰??s in 5 months108FRCPED109Graduated from diploma school nursing program110Have associate degree, but am currently in BSN program111I, N = 3112Im trained midwife113in Doctoral program114In Masters program115In MSN program right now 116in process of obtaining Masters, to be finished in spring.117JD (unrelated to current position)118Juris Doctor, N = 2119L120LM, CPM & Bridge Certificate121Masters and currently enrolled in PhD122Masters in progress (anticipate completion 3/19)123Matriculated in MSN program124MD JD125MD, PhD126Midwife127midwifery certificate128MSN and currently finishing DNP129MSN in progress130ND (Doctor of Nursing)131neonatal nurse practitioner certification132NNP certificate program133NNP certification 134no135NP certificate136nursing 3 year diploma137nursing diploma 1975 plus rnc lrn138Nursing diploma grad 3 years139Nursing Diploma Program for RN140Obtaining my masters degree141PhD student142PhD student, BSN to PHD, finishing dissertation work143Physician Assistant Certification144RN 3year diploma 145RN diploma, N = 12146RN Diploma and working on Masters147RN diploma. We're still around. Also RNC-NIC148RNC diploma149RRT RPSGT150RSCN, RGN151School of nursing152Some graduate153Some midwives and nurses have a DRPh as their doctorate. Also some have DNSc (me for example)154some PhD credits155will complete baccalaureate in less than one year156Working on BSN, N = 2157working on my masters right nowTable 9. APRN as primary role: Verbatim Responses to “Other (please specify)” Table 9. Which of the following types of APRN is your primary role? OTHER (PLEASE SPECIFY) VERBATIM RESPONSES12 classes shy of a MSN in education2Advanced Life Support/Neonatal Transport3Advanced Life Support/Neonatal Transport4also do part time CNS 5BSN6BSN not an APRN7BSN only8BSN-not APRN9BSN, RNC-OB10C-EFM11Certified - Maternal Newborn Nursing12Certified Childbirth Educator13Certified Inpatient OB nurse and Nurse Educator14Certified Maternal Newborn Nurse, Nurse Educator15Childbirth educator16Clinical Assistant Professor17Clinical care leader18Clinical Development Specialist19Clinical Education 20Clinical Education Specialist in OB21Clinical educator 22Clinical educator, MN23Clinical Educator, RNC-MNN24clinical educator/staff nurse25Clinical Mentor26Clinical Nurse Educator, N = 1127Clinical nurse Educator and Simulation specialist 28Clinical Nurse Educator BSN29Clinical Nurse Leader (CNS no longer available when I finished graduate school)30Clinical Practice Support/Simulation31Clinical program developer32Clinical Resource educator33Clinical Resource Nurse34Clinical specialist 35CNL, CNE36DNP37Do not have aprn status38ECMO Specialist39Educator, N = 1540Education Specialist, N = 341Education-Staff Development 42educator for L&D, nursery, postpartum, and pediatrics43Educator MSN44educator, consultant45Family46Family Nurse Practioner, N = 947Family nurse practitioner working atObGyn office48FNP, N = 849FNP not practicing50Have MSN - not an APRN51High-risk OB RN coordinator52I am a nurse educator and in school completing my DNP in Midwifery at University of Illinois at Chicago53I am not a APRN, N = 1354I am not classified as an APRN although I hold a Master's Degree in MSN - Education55I am pursuing a MSN Nurse Educator56I did not select APRN, I selected "clinical/unit educator" ???57I do not have an advanced degree58i do not have an advanced nursing degree, i have a law degree59I don't hold an advanced practice degree60J61Lactation62Leadership63Master prepared Nursing Instructor64Masters in Nursing Education, N =265masters prepared nurse educator for L&D66MNN, N =267MS in nursing with OB clinical and Educator pathway68MSN, N = 369MSN Clinician70MSN Education71MSN education 72MSN in nursing education 73MSN Nursing Education74MSN-ed75MSN, Informatics and Education 76MSN, Nursing Education77MSN/MPH Administration78My Masters degree is in nursing education.79N/A, N = 2480N/A: Clinical Educator/Clinical Analyst for charting systems81NA Not APRN82NCC certified in LRN but not actually APRN83Neonatal Educator 84Neonatal Nurse Clinician85NICU educator86NICU Transport87Not an APRN, N = 2688NONE, N = 1289None of the above. I am an BSN RN90None of the above. MN in Communuty/Population-Based Nursing and certificate in Nursing education 91None. I am an educator 92Not advanced practice, N = 493not an APRN--masters prepared in maternal child education specialty94Not an APRN, have a MHA95Not applicable, N = 396NP Clinical Practice & Education97NPD and LRN98Nurse Educator, N = 2499Nurse educator - MSN100Nurse Educator ( can we make this APRN?)101Nurse educator- BSN102Nurse Family Liaison103Nurse Professional Development Specialist104Nursing administration105Nursing Professional Development Practitioner106nursing professional development specialist107Nursing professional development specialist not adv practice 108OB109Obstetrical Educator and Nurse Expert Witness Medical Malpractice110Perinatal111Perinatal educator 112Perinatal Nurse Practitioner, N = 2113Professional Development Coordinator114Professional Development Specialist115Professional Staff Development Specialist116Professor of nursing education117Regional Nurse Educator118RN, N = 3119RN-C120RN-RNC121RNC- OB122RNC-Inpatient OB, MSN, MHA123RNC-MNN124RNC-NIC certification but I am an Educator. Working on my Nursing Education Certification125RNC-NIC MSN126RNC-NIC, Clinical Nurse Education Specialist127RNC-NIC, Neonatal Clinical Educator128RNC-OB129RNC-OB, IBCLC130RNC-OB, C-EFM131RNC-OB; Diabetic Specialist/DSME/T Coordinator132RNC-on, phd133RNC/Ob c- efm134Staff development and Women's Services Education Develpment135Staff Educator136Staff educator RN137Staff RN138Staff RN and Nurse Educator (for staff and patients) in a Community Health Center139Techinical Advisor140This does not apply to me. Table 15. Areas of current practice: Verbatim Responses to “Other (please specify)”Table 15. What areas does your current practice incorporate? Other (please specify) VERBATIM RESPONSES1Academia2acupuncture and clinical herbalism3advocacy at City, State and national levels4Also PICU and Peds5Ambulatory Care Sites, Emergency Room, ICU & Cardiac Diagnostic Center6Ambulatory high risk hospital clinic7Ambulatory Practice 8Antenatal Testing9Antenatal testing10Attend deliveries of high risk babies11Bereavement12birth certificate registrar13Birthing Center14Board quality. Transport medical director15Car Seat Challenge16Case management MCH ,special care nursery ,and Pediatrics 17Centering18Chair of unit19charge nurse20Chart Review and QA21childbirth ed22childbirth education23Clinical Informatics24Clinical service leader25Clinical Supervisor 26Consultant 27consultation; special projects28coordination of complex patients on other units (inpatient and out patient) in hospital29Critical Care/ICU30Delivery room infant resuscitation 31Discharge planning and utilization review32do antenatal testing and timecards and scheduling33EBP34Education, N =235EHR education, High risk pt care coordination 36Emergency Transport37Faculty at Stevenson University nursing program38Family 39family medicine physician with obstetrics40Family Planning Nurse (Title X)41first assist/ hopsitalist in private practice42Flight nursing43full scope women's health care (midwifery scope includes primary care of women)44GYN, N = 1545Gyn / Family Planning46Gyn and peds47GYN ONC48gyn post op49GYN services50Gyn surgicals51gyn. OB-ED52gynecologic, problem visit, well woman care, cancer screenings, contraception53Gynecological care and family planning54gynecological, women's health, primary care55gynecology; some basic primary care56High risk57High Risk Academic hospital based clinic58high risk deliveries only 59High Risk Maternal & High Risk Fetal, Fetal Surgeries60high risk maternity61High risk ob clinic62High Risk OB Transport, N = 363High risk OB transport, NICU transport64High Risk obstetric testing, NST, MBPP, BPP. Amniocentesis, intrauterine transfusion circulator.65home care66Hospital based MFM Fetal Center67Human Reproduction68I also do specialized audits for the Director of Women and Infants at our level IV Hospital69I also work at the bedside at another facility as a staff nurse in labor and delivery 70I work 40 hours for in academics primary job the 12-24 in practice at hospital, I will focus these answers on practice71I work in a level 3 Birth center, care for patients and the newborn for the first few hours; we have a level 4 NICU72I work with all breastfeeding patients and babies73IBCLC74IBCLC75Informatics, N = 376Infusion therapy77Intrauterine transfusions/procedures78K79L and D80L&D high risk deliveries81Laboratory Transfusion service support82Lactation, N = 2283Lactation, GYN, Perinatal IT system, Risk Management, Quality, 84legal consultant85Legal nurse consulting86Low risk gyn87Maternal Fetal Medicine, N = 1088Maternal Fetal Medicine Diagnostics89Maternal Fetal Medicine- Specifically dealing with fetal anomalies90Maternal Fetal Medicine, consultation and prenatal diagnosis; cerclage, intrauterine transfusions91Maternal Fetal Transport92maternal transport93Maternal transport94maternal/fetal medicine95Med surg96Medical/surgical including GYN services97MFM98MFM clinic99MFM Clinic100Midwifery101MNCH102Mostly NICU, float to others103Neonatal and Pediatric Critical Care Transport (air and ground)104neonatal meaning level two nursery105Neonatal Transport, N = 2106Neuro intensive care107NICU, N = 2108NICU and Pediatrics109NICU graduates in follow up clinic110No 111NRP instructor, BLS INSTUCTOR112OB critical care, fetal surgery113OB ED, Pre op, Intraop & PACU114OB Emergency Department 115OB emergency dept. operating room116OB OR circulator117OB related surgeries (BTL, C/S, D&C, etc)118OB triage119OB triage120OB/Gyn Emergency Room 121OBED 122Obstetric clinic123Obstetric ER124Obstetrical Emergencies 125office obstetrics & gynecology, gynecologic surgery126Operating Room, N = 2127Opioid Use Disorder- Subutex prescribing128Opportunities for nursing advancement, level 1-4.129OR130OR131OR For C-sections and PACU132Outcomes133outpatient and Ultrasound134outpatient obstetrical and gyn care135Palliative Care136Patient Placement Coordinator-all OB137Pediatric 138Pediatric 139Pediatric and ICU area's of the Children's hospital.140pediatric and med surg141Pediatric ICU142pediatric pts who are breastfeeding seen in outpt lactation clinic143pediatric support of infants 144Pediatric , N = 17145Pediatrics and GYN146Pediatrics and Leadership147Pediatrics, patient experience148Pediatrics/PICU149Peds & Neonatal 150peds, PICU, peds ER151Perinatal and women's health (nurse-midwifery curriculum)152Perinatal hospice153perinatal mood disorder154Perioperative - General Operating Room155Physician Peer Review156PICU157Policy development 158Policy development and Magnet program159preconception, well woman160Preconceptual161prenatal class instuctor162Prenatal consultations & attendance of high risk deliveries163Prenatal consults164PRN newborn, PACU full time165professional organization166Pulled PICU167Q168QA, Patient Safety, Risk follow-up.169QI170QI171Quality, N = 4, Quality Improvement, N = 9172Quality improvement perinatal safety173Quality Improvement, Practice174Quality Improvement/Safety175Quality work in all areas176Quality/Safety177Regional Perinatal Center178research tasks179Residents180Residents clinic with high risk OB181Responsible for operation of hospital based Fetal Care Center182Review of potential obstetrical nursing malpractice plaintiff and defense183Risk Management-Safety184RPI185Safety186Sc187Sleep , Adult critical care188SOme labor and delivery issues189special care nursery190Statistics and quality PI improvements191Support of clinical documentation systems192Surgery193Surgical and Perianesthesia services 194surgical some medical patients GYN hysterectomy,appendectomy gallbladder no one with a cardiac history or infectious patient 195System analysis and leading change196Teach community setting how to use Essential Oils during pregnancy, labor, birth, baby and beyond 197Teach STABLE and NRP198Teaching199Team Leading/NICU leadership team member200The education refers to being an adjunct clinical instructor for a major university school of nursing.201Transitions of care202Transport, N = 10203Transport (including HROB patients or attending deliveries, Newborn, Neonatal, and Pediatrics)204Transport Neonatal Nurse205Transport of high risk OB pts & neonatal patients206Triage and Birth center207W208We 209We go to all high risk deliveries in L&D.210women's health, N = 6211Women's Health Center - high risk OB/GYN care212women's health policy213Women‰??s gyn surgeryAppendix SEQ Appendix \* ALPHABETIC D. Task Statements Importance and Frequency Validity Scales – Counts & PercentagesTable SEQ Table \* ARABIC 31. Task Statements Importance Validity Scale - Counts & PercentagesDomains/TasksImportance: How important is this quality and safety task in your professional practice?Not Important (0)Somewhat Important (1)Important (2)Very Important (3)N%N%N%N%Domain 1: Systematically perform ongoing and comprehensive quality and safety assessment and gap analyses.TASK 1.1 Systematically assesses the organization institutional and environmental culture, patient experience and outcomes, leadership and teamwork by using a variety of methods (e.g., surveys, direct observation and/or environmental scans, adverse events, system errors, and near misses) to identify gaps in quality and safety.491%3105%139322%445272%TASK 1.2 Maintain current knowledge of national quality and safety standards and clinical guidelines from regulatory, accreditation, and specialty organizations, to promote ongoing change in practice to meet quality and safety indicators.70%1352%119919%486378%TASK 1.3 Evaluate quality and safety metrics by analyzing baseline and ongoing data to determine current state of performance, identify gaps, and identify opportunities for improvement.541%2965%196532%388963%Domain 2: Promote the integration of quality and safety practices within the organization at the governance and leadership levels.TASK 2.1 Incorporate quality and safety aims, tools, checklists and communication strategies into evidence-based projects to improve obstetric and neonatal care.310%1933%157525%440571%TASK 2.2 Foster team function by integrating leadership and teamwork skills that empower members of the clinical team and improve communication to achieve a climate of safety.230%1412%138622%465475%TASK 2.3 Educate and train obstetric and/or neonatal teams on quality and safety practices by conducting and debriefing team training exercises and implementing education using effective learning principles to improve task knowledge and optimize team functioning (e.g. mock codes, simulations).300%1593%150224%451373%TASK 2.4 Advocate for ongoing resource needs by serving as a liaison for quality and safety matters between clinicians and administrators (e.g., participating in meetings, serving on committees and through risk assessment activities) to improve care and outcomes.401%3245%206933%377161%TASK 2.5 Inform patients, colleagues, employers and the public about quality and safety initiatives/outcomes by disseminating outcome data, participating in benchmarking and publishing reports to maintain transparency.881%60210%236538%314951%Domain 3: Develop and implement quality and safety initiatives in obstetric and neonatal practiceTASK 3.1 Select and monitor key quality metrics that assess a balanced set of quality and safety domains indicative of organizational culture and benchmarking.1072%62910%242239%304649%TASK 3.2 Apply recognized methods to improve quality and safety (e.g., model for improvement).260%2875%217935%371260%TASK 3.3 Design quality and safety initiatives in collaboration with necessary stakeholders to identify the target population, measures (e.g., structure, process, outcomes) and data collection approaches to address identified opportunities.1142%66111%250640%292347%TASK 3.4 Promote quality and safety practices by using error prevention strategies and appropriate technology to facilitate improvement initiatives.341%2564%192231%399264%TASK 3.5 Integrate effective interventions into daily clinical workflow, using principles of high reliability, to guide practice and improve outcomes.270%1993%185130%412767%Domain 4: Evaluate and measure the effectiveness of quality and safety practices in obstetric and neonatal careTASK 4.1 Evaluate the implementation of quality improvement initiatives using relevant tools (e.g., fishbone, flow chart, run charts and control charts) to measure effectiveness of processes and outcomes.2163%94315%263843%240739%TASK 4.2 Articulate the value of specific obstetric and neonatal quality initiatives by evaluating the balance between quality, outcome and cost, including the perspectives of all stakeholders (e.g., healthcare team, patients, and families).1563%80513%255641%268743%TASK 4.3 Identify strategies of moving quality improvement initiatives into sustainment in order to maintain positive change in an overall obstetric and neonatal quality and safety program.751%4688%244439%321752%Domain 5: Professionalism and ethical practiceTASK 5.1 Demonstrate an ongoing commitment to lifelong learning and continued competence by keeping abreast of evidence-based practices related to quality and safety in order to optimize outcomes, improve system function, and reduce potential for harm.50%972%114819%495480%TASK 5.2 Establish mechanisms to incorporate existing, updated, and new regulations related to quality and safety into obstetric and neonatal care to facilitate compliance with regulatory standards.361%2764%213034%376261%TASK 5.3 Ensure optimal disclosure of adverse events by developing and implementing standardized processes to promote transparency, patient trust, and risk mitigation.431%2594%189130%401165%TASK 5.4. Demonstrate professionalism by applying ethical principles (e.g., fairness, truthfulness, justice, beneficence, nonmaleficence, autonomy) relevant to patient safety and quality activities (e.g., RCA, disclosure) to maintain personal and institutional integrity and to foster a culture of safety and organizational excellence.140%1362%135422%470076%TASK 5.5 Provide support to patients, families and staff following an adverse event by implementing appropriate and standardized processes to minimize negative psychosocial consequences and mitigate risk.391%1593%149724%450973%Table SEQ Table \* ARABIC 32. Task Statements – Frequency Validity Rating Scale – Counts & PercentagesDomains/TasksFrequency: How frequently do you perform this quality and safety task in your professional practice?Never - I do not perform this task (0)Rarely - Once or twice per year (1)Occasionally – Every 2 to 6 months (2)Routinely – At least once a month (3)Frequently – At least once a week (4)N%N%N%N%N%Domain 1: Systematically perform ongoing and comprehensive quality and safety assessment and gap analyses.TASK 1.1 Systematically assesses the organization institutional and environmental culture, patient experience and outcomes, leadership and teamwork by using a variety of methods (e.g., surveys, direct observation and/or environmental scans, adverse events, system errors, and near misses) to identify gaps in quality and safety.65010%4888%87214%189731%229737%TASK 1.2 Maintain current knowledge of national quality and safety standards and clinical guidelines from regulatory, accreditation, and specialty organizations, to promote ongoing change in practice to meet quality and safety indicators.2654%3686%96816%243139%217235%TASK 1.3 Evaluate quality and safety metrics by analyzing baseline and ongoing data to determine current state of performance, identify gaps, and identify opportunities for improvement.94515%5809%103617%215335%149024%Domain 2: Promote the integration of quality and safety practices within the organization at the governance and leadership levels.TASK 2.1 Incorporate quality and safety aims, tools, checklists and communication strategies into evidence-based projects to improve obstetric and neonatal care.5098%5258%104117%203133%209834%TASK 2.2 Foster team function by integrating leadership and teamwork skills that empower members of the clinical team and improve communication to achieve a climate of safety.3295%4107%85414%192831%268343%TASK 2.3 Educate and train obstetric and/or neonatal teams on quality and safety practices by conducting and debriefing team training exercises and implementing education using effective learning principles to improve task knowledge and optimize team functioning (e.g. mock codes, simulations).62210%82113%180629%197432%98116%TASK 2.4 Advocate for ongoing resource needs by serving as a liaison for quality and safety matters between clinicians and administrators (e.g., participating in meetings, serving on committees and through risk assessment activities) to improve care and outcomes.86214%67911%119819%227437%119119%TASK 2.5 Inform patients, colleagues, employers and the public about quality and safety initiatives/outcomes by disseminating outcome data, participating in benchmarking and publishing reports to maintain transparency.148624%91115%126120%162226%92415%Domain 3: Develop and implement quality and safety initiatives in obstetric and neonatal practiceTASK 3.1 Select and monitor key quality metrics that assess a balanced set of quality and safety domains indicative of organizational culture and benchmarking.167827%74612%113118%174428%90515%TASK 3.2 Apply recognized methods to improve quality and safety (e.g., model for improvement).61810%65010%135722%215635%142323%TASK 3.3 Design quality and safety initiatives in collaboration with necessary stakeholders to identify the target population, measures (e.g., structure, process, outcomes) and data collection approaches to address identified opportunities.175628%89914%133321%154325%67311%TASK 3.4 Promote quality and safety practices by using error prevention strategies and appropriate technology to facilitate improvement initiatives.71512%5659%105017%189731%197732%TASK 3.5 Integrate effective interventions into daily clinical workflow, using principles of high reliability, to guide practice and improve outcomes.4207%3806%91315%183230%265943%Domain 4: Evaluate and measure the effectiveness of quality and safety practices in obstetric and neonatal careTASK 4.1 Evaluate the implementation of quality improvement initiatives using relevant tools (e.g., fishbone, flow chart, run charts and control charts) to measure effectiveness of processes and outcomes.209434%89014%128021%127020%67011%TASK 4.2 Articulate the value of specific obstetric and neonatal quality initiatives by evaluating the balance between quality, outcome and cost, including the perspectives of all stakeholders (e.g., healthcare team, patients, and families).213134%87014%120419%132621%67311%TASK 4.3 Identify strategies of moving quality improvement initiatives into sustainment in order to maintain positive change in an overall obstetric and neonatal quality and safety program.155225%89614%135522%162926%77212%Domain 5: Professionalism and ethical practiceTASK 5.1 Demonstrate an ongoing commitment to lifelong learning and continued competence by keeping abreast of evidence-based practices related to quality and safety in order to optimize outcomes, improve system function, and reduce potential for harm.1182%2304%96015%252941%236738%TASK 5.2 Establish mechanisms to incorporate existing, updated, and new regulations related to quality and safety into obstetric and neonatal care to facilitate compliance with regulatory standards.93715%66811%143223%213834%102917%TASK 5.3 Ensure optimal disclosure of adverse events by developing and implementing standardized processes to promote transparency, patient trust, and risk mitigation.120419%78913%117419%176728%127020%TASK 5.4. Demonstrate professionalism by applying ethical principles (e.g., fairness, truthfulness, justice, beneficence, nonmaleficence, autonomy) relevant to patient safety and quality activities (e.g., RCA, disclosure) to maintain personal and institutional integrity and to foster a culture of safety and organizational excellence.3155%4016%81313%159926%307650%TASK 5.5 Provide support to patients, families and staff following an adverse event by implementing appropriate and standardized processes to minimize negative psychosocial consequences and mitigate risk.62910%100216%133121%162426%161826%Appendix SEQ Appendix \* ALPHABETIC E. Survey respondents' comments about the task statementsTable SEQ Table \* ARABIC 33. Survey respondents’ comments about the task statementsTASK STATEMENTSIf you have any comments about the comprehensiveness and/or accuracy of the task statements, please enter them here. If you believe that there is a missing task statement, please indicate the task.Types of ResponsesNumber of ResponsesPercentage of ResponsesComments such as: None, Nothing to add, N/A, Nothing or none at this time, None missing, or "0"29849%Marks, such as "…" or "Xs"264%Comments28046%Total604100%TASK STATEMENTSIf you have any comments about the comprehensiveness and/or accuracy of the task statements, please enter them here. If you believe that there is a missing task statement, please indicate the task. Verbatim comments, N = 280153. TASK 5.5 Provide support to patients, families and staff following an adverse event by implementing appropriate and standardized processes to minimize negative psychosocial consequences and mitigate risk... how often is an extremely response. If i say never, it is possible because that I have never had an adverse event. If I say weekly, it sounds like something is going wrong all the time. Think about this wording. 2A bit unclear if these are supposed to address individual practice or the standards to which our entire unit adheres to. 3A choice might be: Routinely as needed4A lot of these tasks are someone else‰??s JOB. They decide/ evaluate / compare cost/ etc..... It is all very important stuff, but 95% of my time is spent at the bedside, and my opinion is rarely asked.5A significant issue related to safety is the method in which errors are handled by managers and administrators. Environments that support retaliation, or conversely, ignore concerns that are raised, contribute to suboptimal safety and failure of staff to report miss or near-miss events.6Accuracy of the answers is compromised by the way the question is asked about performance of task. If there are fewer incidents, and therefore no need to report, the results are skewed.7Again another survey with waaaayyy to much nursing jargon and buzz words. Would do better to have clear concise topics and avoid all the ‰??nursing-see‰??8ALL GREAT IDEAS! We can theoretically agree on these concepts and yet NOT be able to implement. We don‰??t even get breaks or lunches, much less any time to examine, design or implement a quality plan. When some new safety/quality issue comes down the pike, something else has to go. 9All important but not operationalized into current work processes10All important, some items ex. RCA are routine when warranted but if all processes are working well it will only be occasionally needed11All lot of what I marked as do not do is because as a staff nurse I am not given the opportunity to do but if these improvements or strategies are implemented at the bedside I always incorporate them into my care.12All of the previous questions are handled by a dedicated Quality Improvement Team. They are not inclusive of the Clinical Educator role nor disseminated out to the Clinical Educators or staff at the hospital that I work at. They are 2 different roles.13All of the previous tasks are tasks that we implement in my unit at all times. If I do not perform the tasks myself, my nurse manager or assistant nurse managers do. That is why some of the answers were answered as occasionally or routinely. Although they are performed at all times, I do not always perform them personally. I do believe my unit has a small percentage of errors because we have a lot of check and balances in place preventing errors to the best of our ability 14All of the saftey domains are very important to myself and my coworkers, unfortunately the management and administration where I work are only interested in cutting costs and keeping saff to a minimum.15All of the task are of vital importance. As a Masters of Health Law and Policy student I am a strong advocate for these tasks. But Leadership must take ownership of these concepts as well and the organization I work with does not. 16All the questions were very productive and straight to the point. This exactly this type of innovation that we want bring into our practice. 17Although almost all of these are vital for safe quality practice in OB as a staff nurse I am involved only on the fringe ESP as it relates to incorporating changes in practice18Although I marked all important, but also not involved. This is due to new management in the hospital. They do not include staff nurses in any of the processes. As a matter of fact we were told that we shouldn‰??t say anything in the committees we are on!19Although these tasks are all very important, many of us have other groups and committees that monitor regularly. There are many routine items we include, as necessary in our day to day clinical practices.20Any high risk event or adverse event is reported and handled also per event.21AS A BEDSIDE NURSE I FEEL IT IS IMPORTANT BUT I AM NOT DIRECTLY RESPONSIBLE FOR THE DATA COLLECTION, MONITORING AND IMPLEMENTATION OF THESE TASKS PER SE.22As a bedside nurse, I am frequently told to implement a new quality & safety initiative, but not given the tools to effectively carry it out, making it impractical23As a member of a very large institution many of these ‰?÷tasks‰?? are attended to by our PCD and CNM. 24As a per diem staff nurse, I do not personally participate in many of thes tasks.25As a staff nurse I see the importance of all 5 domains, however mgt. Doesn't want to hear about processes that need improvement and routinely make risky staffing decisions. 26As a staff nurse, many of these measures are very important to me, but I am not part of the design or evaluation piece27As a staff nurse, my participation in some of these important measures is not welcomed by the leadership of the organization 28As a traveler I very rarely have the opportunity to do most of the things covered in this survey. 29As I filled this survey out, I saw overlap in many roles such as QI Manager, NICU Manager, CN's APRN role.30As I'm sure many will say, my role only plays a part in those task statements. I help with some but it may not be my main role to move things forward. 31At my facility I don't have an active role as a leader in doing safety and quality. There is much apathy at my unit to participate in committees and poor follow thru from leaders on keeping the committees going and active. Nurse at my facility feel like they have no voice and try to bring up issues but they never get resolved or even the slightest change. Which is ironic because the administration is seeking magnet status. They fail to recognize the contribution of nurse for pt advocacy safety and qualtiy32Audits and stats done monthly. Possible process change. Educate staff33Being a staff nurse, I am not involved in many of the quality/safety initiatives per se34changing environment of healthcare nurses have limited or no inservice time for the CNE to teach and evaluate outcomes. Focus is shifting to self learning; which is difficult to assess competency 35Clinical educator and Assistant Nurse manager perform many of these functions at our hospital.36Currently implementing principles on becoming a high reliability organization. Am an instructor for mandatory HRO safety training taking place at our organization. Also, our institution is a member of solution for patient safety, a collaborative of over 100 hospitals nation wide. I have had significant training on HRO through that collaborative as well and is member of core group that implemented and participates in weekly Safety event classification mtgs and the 3 meeting RCA model, being one of the primary investigators when RCA is warranted for serious safety event 37daily near miss issues38Daily safety Huddle with staff have been invaluable to insight for our unit and improving safety and quality 39demographic question on where survey respondent lives might not be gathering data you want. I live in Nevada and work in California.40Designing processes and simulations when problems are noted in team communication or team work. 41Develop data reporting metric to measure quality outcomes. Engage frontline staff in quality and patient safety42Didn't understand some of them, but answered to the best of my ability43Events don't happen everyday due to pt volume, for example debriefs of critical events. When we have them, i.e hemorrhage, resuscitation, stat C-sections we do debrief after the event and or within 24 hrs. We do emotional debriefs in collaboration with our social services also, usually within the first week44Excellent statements45Excellent statements!46Excellent statements. 47Excellent summation of the Perinatal Safety Nurse Role. Wish there were an exam for this that encompasses, quality, safety and clinical practice48excessive jargon49For someone who is not an administrator, it can be hard to identify the ways I participate in quality/safety, but my institutions do employ a lot of checklists and protocols that I comply with every day. I assume that someone in a more administrative role is doing the work of seeing if these checklists actually work.50Great questions. As an NNP working as a contractor to many organizations, it is difficult to participate in planned change and action plans. While I may integrate new practices in my day to day worker bee life, I am rarely asked or allowed to be an active participant in culture change. This is one of the largest dis-satisfiers of my professional career.51great tasks 52Hard to figure out if the questions are job related or something outside the scope of job description that an individual implements in their practice 53Honestly, I am a little unsure of exactly what some of the tasks meant, so I answered to the best of my knowledge/ability.54Hospital should pay more for all the training, extra time to learn and master new tasks, more hands on training with educators.55I56I also teach AWHONN fetal monitoring to nurses in my hospital's system.57I am a clinical nurse so I do not implement the training of these tasks but the nurse managers do frequently on our unit 58I am a provider. I am peripherally involved with developing protocols and policies, but I do implement things like safety bundles, checklists, time-outs, informed consent, etc. in daily practice.59I am a Retired OB RNC. I worked in a high risk acute OB hospital setting for my entire career of 43 years. I held a management position in a high risk obstetric unit for 10 years and was a charge nurse and staff nurse for the rest of my career. My monthly staff meetings always had a section on safety, quality and ways to improve care by improving the RN work environment. 60I am currently in an educational position at a local community college. I work part time at my local hospital. I have tried to answer these questions related to both facilities. 61I am currently not working due to having to be home to help my parents who were in an accident. When I was employed I was very involved in these initiatives and worked very hard on committees and task forces to improve quality of care and also patient and employee satisfaction. 62I am feeling a growing disconnect between the bedside clinical practice and administration being aware of how necessary it is to provide, recognize and support what is needed to give excellent, best care, evidence and outcome based care at the bedside. 63I am frustrated and annoyed by all of this complicated and convoluted language that means absolutely NOTHING to staff nurses that are being worked to death every day. THE MOST IMPORTANT thing needed to maintain safety on the unit and in a Highly Reliable Organization is SUFFICIENT STAFF TO MEET ACOG AND AWHONN GUIDELINES. It is absolutely ridiculous to go on ad nauseum talking about safety in verbiage that assumes we can attain safety by some miraculous magic obtained from initiatives, analizations and a group of white coats sitting around wasting vast amounts of time and money when what is needed is more staff. On a weekly basis , staff nurses are informed that they have to perform yet another task (that is not patient care - it is in the computer) - they have to do "just one thing". After about 6 or 7 years of these added "just this one thing" I would like to know who is evaluating the absurd number of "just one more thing" that is added to the staff nurse's list of nonsense that goes in to the computer. The people that are dictating all of this have absolutely NO IDEA what a staff nurse has to do because they do not have to do it! They are administrators and managers that are so far removed from patient care that they seriously HAVE NO CLUE! All of this nonsense is a waste of time , energy and money. Nurses are not taking care of the patient. They are taking care of the computer. Just to open everyone's eyes, this type of charting encourages to not be truthful when charting . Administration, managers and the people who are in control of all of these initiatives, protocols, procedure's, and tasks, etc... should have to work on the unit as a staff nurse AT LEAST once a month to become familiar with the impact their mandates are making on the staff nurses ability to safely take care of their patients. It would also allow them the opportunity to evaluate the staff nurse patient load . It would become very clear that all their mandates mean nothing when their is inadequate staffing. Heads up! Staff nurses have people's lives in their hands...They do not have breaks, lunch or go to the bathroom... They should not be overworked and stressed to the breaking point.... they have a VERY SERIOUS JOB and need the time and energy in their patient load to perform their job safely. All the young nurses coming out of school are in Master's program... their first job as a staff nurse makes them say to themselves "Yeah, I'm getting out of here... I have to work too hard, I'm not going to work like this all my life... This is dangerous and stressful everyday!". So they'll all become NP's or PA"s... So! Who is going to be at the bedside taking care of the patients???? SAFETY BEGINS WITH ADEQUATE STAFF! 64I am in a supportive role to carry out safety initiatives, but do not lead/manage these tasks.65I am not a manager or educator by title but I do teach neonatal resuscitation and review care with fellow workers and staff as well as patients. I keep up with reading and certifications as IBCLC and Inpatient Obstetrics, S.T.A.B.L.E, ACLS and PALS. I have also taught BLS. I am a nursing instructor clinical and lecture. I believe daily practice incorporates safety, review of process and use of all tools available to use acquired knowledge available to us from research. 66I am not in an administration position but try to use principles in my everyday practice as RN67I am not on any quality committee that does these services at my institution.68I am not sure I truly understood the statements and how it relates to me as a bedside caregiver.69I am not sure if some of the areas were really part of bedside nursing. So I did my best at guessing. All areas are important to the NICU.70I am thrilled to see NCC developing this certification. As a CNL, my professional framework centers on quality, safety, and ongoing analysis of outcomes to continuously grow and develop quality on our unit and within my facility and health system. Our organization brought High Reliability in Obstetrics training to all MDs and RNs in 2006. This has continued to impact us and our patients on a daily basis. 71I answered as best I could. Whenever we have a bad outcome we follow all protocols and RCA each case72I answered questions based on professional practice on my unit. 73I answered these questions, query as a Staff Nurse. I am also a clinical educator for a University and did not use that position to answer the questions74I believe in all of these obligations but don‰??t feel our practice has the autonomy to positively influence all the categories. 75I consistently provide support and seek transparency with adverse outcomes every day I practice but adverse events are rare in my practice. 76I do not believe there are any missing tasks but they need to be separated into clinical staff and managerial staff. 77I do not initiate improvement measures but work with clinical faculty to determine and implement educational strategies.78I do not work in an environment that allows MFM to be involved in hospital based safety initiatives79I don't know if your data will be very accurate because it was hard to determine exactly what some of the measures meant. Also, there are many processes that I am around for and lend my support to, but I'm not necessarily doing them myself. 80I don‰??t feel this is a good survey. There are many different groups and committees, some overlap and some have overlapping goals and outcomes81I don‰??t have much opportunity at the hospital I work at to make any changes or offer and ideas for changes. 82I feel like some of these tasks are better accomplished at the administrative level, which made it hard to answer in regards to my involvement 83I feel that the end of life aspect in the neonatal and labor and delivery units are always excluded from the professional service. 84I feel that there should be a protocol for hospitals to adopt to foster Nursing Research. It is what I amm doing my DNP print on85I feel that these benchmark analyses, tactics and processes slow bedside interactions, and from my experience with my institution are passed on to the clinical staff, slowing our responses and interfere with patient care. The focus is the benchmark and the pie chart, not the patient.86I felt while many of the task statements are important the implementation of them are mostly done by management and our education department and disseminated down to staff87I know the importance but as a staff nurse where I work we have no voice.88I love quality. I have much more training and experience in this area. It is much needed at my practice but my boss does not see the value. I worry that we will have a poor outcome before anyone starts caring about quality measurements and projects. 89I personally feel these are critical and important - HOWEVER your answers should have included an option to say my current employer doesn't support this so I cannot carry it out because my employer's culture doesn't allow it. I did many of these in a previous role with a better/previous employer90I really want to provide and promote safe patient care.91I spend the majority of my time in my current employment on Perinatal Patient Safety Initiatives .92I strongly believe in ongoing education, transparency and family support. Throughout my career, I have always surpassed my organizations requirements for CE because I believe in staying informed of current practice and technology changes. Fortunately, we don't have many adverse events for which I feel families need to be supported, but when we do, family relations are one of my strengths.93I teach and do clinical on a obstetrical floor, students are involved in process improvement, but I do not have any input into the OB floor processes.94I think all of these things are very important, but I don't think the culture in our facility always fosters an environment to implement them.95I think communication of performance on our objectives is the most common task‰??and underrepresented in the survey so far‰??whereas implementation of *new* strategies is less common. 96I think for contracted staff it is less likely that they will be engaging in as much of the change process. Might be good to know if the respondent is working in the place where they are employed or if they are contracted to a hospital.97I think for some of the answers, it would be good to include "as necessary". For instance, RCA's - we do them as the need arises, which didn't really fall into any of the categories available.98I think it covers important aspects of quality99I think it may be diffucult to measure results of this as my titile is ‰??Advanced Nurse Clinician‰?? yet the title that closely aligned with my role was educator. I do so much more, but in a health system of my size, we have multiple roles performing some of these very important tasks. Smaller institutions may have less people performing more work.100I think that everything we do daily as leadership in these areas is focused on high quality care and best practice and fits one or more of the tasks. It was difficult to say you only do some of these occasionally or infrequently because all are so important. 101I think that they are a little tedious102I think there is a difference between how often does the survey participant participate in these activities and how often the institutions participates. 103I think these are very broad and difficult to understand and apply, I guessed on most of them. I almost quit the survey at this point because it was too difficult to understand and apply 104I work 2 days a month. I am semi retited. THIS is why i checked monthly. I incorporate these each time i work105I work in Academia. Evaluating quality and safety tasks is not part of my professional role. 106I would like this all written up- it covers my job description as a Perinatal safety Nurse107I'm a basic staff nurse. I'm not on any committees, etc. that would be doing any of these items.108I‰??m not in an administrative position to be able to install any of the tasks. 109I‰??m not sure what this is all about. I believe patient safety comes from physicians taking care of patients. Hospital initiatives generally interfere with this.110Identifies areas where evidence or current best practices are lacking and develops reasearch protocols to bridge the gap 2. Participates in regional, national and global dissemination of new evidence related to quality and safety111Identifying inequities, racism, and unequal treatment for different groups of people who differ from the dominant culture and ethnic heritage of the caregivers. 112if less than a year it is because no patient problems are existing113Implementation of these lofty goals into regular practice in different environments (academic teaching hospital vs private practice settings ) is the issue. No one can deny the benefit of the stated goals - local governance teams (nursing/physician/hospital) need to be identified to maintain the momentum of positive change for the good.114Important to address all member of the team with responsibilities in quality outcomes. Many items are ‰??very important ‰?? but cannot be accomplished by nursing alone. 115In a community hospital without research resources and a single practicing neonatologist many of these categories are poorly met.116In response to cost vs outcome that should not be an issue. My position as director divides my administration/clinical time 30/70.117In the clinical nurse role, some of those responsibility do not come into practice regularly, but rather are overseen by management.118It all seems like fluff, charts and graphs etc. but reality is the numbers are manipulated, not actually earned. Unsafe patient care is happening to appease the productivity numbers which is unsafe practice. 119It does need to be evaluated much more frequently and systema 120It is a complete, thoughtful list of statements. 121It is comprehensive122It is difficult to accurately reflect the frequency of some tasks. While the statements may reflect important values, the situations they describe may not occur in situations which I am directly involved on a regular basis. For instance, the frequency I responded to disclosing adverse events was not very often, but when there is an adverse event I am involved with, it would be of utmost importance to disclose it and follow the necessary procedure to resolve it at every occurrence.123It is difficult to articulate some things as finite tasks as they are incorporated into all tasks as behaviors that are demonstrated within all work performed, not stand alone items124It is difficult to quantify how often as it depends on how often an event happens125It may seem that my corporation does not spend much time on safety and quality of care. I work for a physician group and it is the physicians who make all the decisions, nurse practitioners are not involved in planning or even implementation. And since we are contract employees we don't have much to say about how the hospital directs and implements care practices. 126It was difficult to accurately state how often I participate in the tasks because so many things are hospital driven. I participate weekly in quality and safety rounds. We address issues as they happen so it‰??s not always easy to put into one of these categories 127It was often difficult to discern the subtle differences between some of the tasks (many sounded similar). Some were full of so much jargon, that they are incomprehensible.128It would be nice to have them articulated in plain English, and not have entire sentences composed of Buzz words!!!129It would help to explain my role. I pretty much function as a CNS on night shift with a staff of 95% new (less than 2 years experience) nurses. My job is to provide support, fill in knowledge and practical gaps, make sure that protocols are being followed, and provide new education. I am constantly observing and listening to the staff and providers for issues. These issues get brought back to management, who choose to follow through as they deem fit. I do not participate on any committees per managements decision. Therefore while I do most of items mentioned in the questions, it is in a a very basic, in the moment type situation in an attempt to promote practical, every day evidence based practice for bedside nurses.130It's difficult to provide an answer regarding frequency for the questions about adverse events. In this incidence, we would always provide transparency and support, but these type events are rare. You are hopefully not going to have adverse events once a week or monthly. The wording makes it sound as if you "rarely" provide transparency, support etc. when in fact you rarely have the type event that you would need to address this way.131Make attempts to assist with system improvement to improve pt experience. I am an employee and not an owner so I adjust to corporate rules as well. 132Many issues overlapping. I identify these items but not in a supportuve environment to enable development and implication133Many items overlap. Not in a QAQI supportive environment so structure may not be formal but I try to establish a process134Many of the questions were the same, just asked in a different statement. 135Many of these tasks are assigned to specific member states of our unit‰??s staff or management, so each individual may not actively perform them.136Many of these tasks are bundled into regular meetings and initiatives. However sustainability of those initiatives is difficult.137Many of these tasks are done by other staff. Most of us attend 1-2 meetings a month for various topics, ie. Performance improvement at unit and hospital level, magnet, just culture, Vermont Oxford benchmarking, joint commission, and others. 138Many of these things are things I would participate in if they were being addressed in the private practices and the hospital where I work. My perception is there is very little actual organization of quality assessment.139many tasks are important to me as a clinician. Less important OR difficult to implement by administration140Maybe it's because I work as a staff nurse and not in administration, but it seems like a lot of these task statements have a lot of great "buzz words" but are actually kind of vague and non-specific.141Mentor those in undergraduate nursing programs in safety/quality initiatives by including them in disucssions/meetings, etc during clinical time.142Most of above are done by committee members, administrative staff and chairpersons of departments, not regular staff143Most of the quality and saftey initiatives I am involved with are due to being a part of the Vermont Oxford Network. Most of the duties associated with this are divided between a large group of nurses, administrators and the medical team.144Most of the task is done routinely while caring for the patient and family.145My daily practice consists of clinical research with infrequent overlap of quality improvement.146My facility doesn‰??t practice evidence based the way it should be. 147My facility is in the process of implementing the Texas AIM initiative 148My focus is as a IBCLC working in a NICU, as a RNC-NIC for over 30 yrs149My individual practice differs from our group practices described in the above questions.150My job is clinical. Very rarely do I do several of the tasks noted. I am on committees involved in this, but our CNS, research and QI people do most of this. 151My position is a staff nurse. I found all of the tasks important for any OB NICU nurse to be aware of. 152My responses are not entirely accurate because the statements were largely action statements that are only allowed to be done by people in leadership/administrative positions. So while I would like to perform these tasks, I am not necessarily allowed to initiate the tasks in my institution. Was I supposed to answer what I would like to do, or what I actually do due to my institutional limitations?153NNPs are not used as support for ongoing development of quality measures in the NICU... these are driven predominantly by nursing management/administrators and we are told what to do. Our input, unless it is totally positive, is not well regarded 154New idea155no excellent job on task stmts... There must be independent ( from the hospital) patient safety advocates easily and readily accessible by patients and families156No missing task statements but the frequency with which I do these things is dictated more by how often I'm on the OB floor rather than by how important/how much I value them.157Not real sure about what I just answered ... but pt care and safety are very important and we are always trying to update and keep up with changes that benifit our staff and pt‰??s158Not really sure why I'm taking this survey as these are all mgmt questions. 159Not very clear to me. Answer to best understanding 160Often as a staff nurse, you are aware of what needs to be done but are limited in effecting change161Often difficult to get information about safety that may be happening at other places in the country.. not a transparent system in regards to national news on safety in other areas..162often the tasks are completed by someone in another role, so the question was about the role in which I function rather than my personal goals163on the "how frequently do you perform"?, not exactly sure how to answer. as a bedside, direct pt care RN I "do" implement safety measures all of the time, but I am not directly involved in performing "the make up, evaluation of the measures" -- that is our managers job and she informs of us benchmarks etc. during monthly staff meetings164One task statement was so long that, by the time I completed reading the statement, it was hard to recall what the task statement was asking of me. I did not have time to read back to see to which task statement I was referring.165Orientation of new staff. Major time involved.166Our unit holds a meeting at the start of each shift to review goals, safety measures, outcomes, events, and any updates in regards to our patient care and management. Our clinical staff is split up into groups of 4-5 people to form committees that are responsible to manage and oversee different goals and improvement measures.167Perhaps actual time allotted to these functions. Measuring time allotted against time necessary to appropriately address all safety and quality concerns and initiatives. Measuring specific resources available organizationally to help support.168Practice and perform collaboratively with all professions involved (such as a megacode). With everyone working to the highest scope of their license.169professionally all are very important, my current clinical environment makes it difficult to say the I implement or provide however I am very active at the state level.170Quality and Safety is of utmost importance in our unit171Questions are too long, need to have a clearer focus172Questions difficult to answer as a PRN OB staff with a history of 25 years management and now teaching nursing FT while working on DNP173Rather than pose the question "how frequently do you...", I think it is more appropriate to ask whether or not the "culture" of an operating hospital unit allows for participation in these processes, are the leaders receptive to input, do they value /validate areas of concerns and need for change, is the staff engaged and encouraged to participate as these facilitate interactive group dynamics and true implementation of initiatives, sponsorship/stewardship by all members. I worked at an institution whose chairs, said all the right things, even had all the right intentions but did not validate safety concerns because of peer pressure and poor leadership. Concerns fell on deaf ears in spite of industry recommendations for safety in practices. 174Regarding education and training, that does not directly apply to those in leadership in terms of performing the task. However, I answered based on expectation/support/promotion. The same is true for the use of Quality tools. I do not implement these tools, but I do consistently review, interpret and help my team develop next steps based on what the Quality Department reports.175Regulatory and ‰??quality‰?? is hurting patients and families. 176Repetative177Reviewing results of surveys with staff, creating action plans as needed to improve outcomes178Safety events are taken care of when they happen- not necessarily once a week.179Seemed to be repetitive but said in a different way more than once.180Several of the task statements are above my level of responsibilities181Smaller facilities handle these tasks differently but we look at team approach vs individual approach for most areas. As a traveler, I take many ideas place to place and use information from AWHONN and journals to assist change182Some are done on an institutional level with individual participation.183Some are more management responsibilities 184Some items I haven't had to do as our number of sentinel events, significant risk occurrence is low185Some of my the tasks listed are not my sole responsibility but I am involved with them in a more supportive capacity.186Some of the answered "no" questions I might speak to in my educational classes but I do not participate personally at my home institution.187Some of the domains are not things were perform on a weekly or monthly basis because the collection of data may take longer so larger time frames were chosen....not to be misunderstood as us not doing it often because of apathy. 188Some of the questions do not apply to me in my work 189Some of the statements are n/a190Some of the statements were hard to understand whether it was something in standard bedside nurse practice or something that a committee or particular job role entails191Some of the task statements do not directly involve me and are done by management. They are either later discussed with myself & other staff or delegated to us (depending on what it is).192Some of the tasks are performed in my facility but not by me I answered questions based on unit practices 193Some of the tasks mentioned I do not implement as a staff RN.194some of the tasks regarding the use of data are performed by our data team and not in the purview of the quality specialists. Also some of the safety and environmental tasks are performed and maintained in our safety/risk management department. 195Some of these are hard to quantify because they don‰??t happen in a pattern. For example if there is an adverse event we have open dialogue with the family about it. If it happened every week we would speak with them but you could have 2 in one week then none for several months. 196Some of these tasks are implemented constantly - on a daily basis. Also, a 2-6 month range is quite broad. Doing something every 2 months is quite different than just twice a year. 197Some of these tasks are important to my organization but not part of my personal professional role. 198Some of this is done at the staff level and some is done via multidisciplinary committees, we are on a journey and have significantly improved front line staff reporting of safety concerns199Some of those questions were difficult (RCA for example), we respond quickly and are accountable. Because we do not have a lot, it is hard to state the timing given the randomness of each incident or concern addressed. I answered as I would if one occurred. 200Some things are not applicable...ie if there are no changes, then none can be implemented. If no adverse events, likewise. Risk management policies ( lawyers etc) also prohibit disclosure of adverse events, family communication etc. Don't put it on the individual nurse or providers. 201Sometimes we perform or report the tasks to others in charge if there are situations rendering that. I am not the one compiling the information or technically gathering info. When a situation arises we discuss it. 202Sorry, but many of them sound like Mumbo jumbo. We need qualitynurses at the bedside, not in a room deciphering flow charts and coming up with procedures that make no sense and more side work for the bedside nurse. 203Staff nurses are not given time and opportunities to contribute to improving standards of care and there are bureaucratic roadblocks 204Task statements are difficult to answer if you are an educator, they are driven from a clinician's viewpoint. Nursing faculty teach many of these very important tasks, but do not participate in them at the facility level.205Task that address the adherence of quality initiatives by all members of the team including attending physicians and residents and how are members of the team held accountable. 206Tasks are implemented by management207Teach and facilitate direct professional and respectful communication between team members when there is conflict or disagreement Facilitate standard expectations and practices to encourage team and individual accountability Create and environment where the individual team member values and prioritizes the larger whole including the team, department system for the benefit of the patient and family 208Team bundle, educational resources 209Thank you210Thanks211The abuse of staff members by the boss needs to be included as a quality measure212The campaigns and Awareness program in remote area for the public should be done occasionally ,213The challenge is the amount of time and resources to achieve the optimal outcomes. Especially with some many competing priorities that it is hard to get things hardwired before the next thing is required or being distracted by other necessities of practice. It's also difficult with physician partners who are focused on the financial or academic perspective and the status quo for patient quality. 214The clinical agency determines how these task statements are carried out not faculty from outside215The discrepancy between my ratings of importance and the actual frequency of implementation in my practice is because my clinical position is "prn" and I do not have these tasks as a part of a leadership role.216The hospital I work at is very attuned to these tasks statements, some areas marked as I do not perform, means data and analysis is done, but I am not directly involved in that process 217The items I answered as "do not perform this task" I wasn't sure I answered correctly. Those tasks are done in our organization, just not by me.218the questions are difficult to answer depending on the hierechy of the institution. for instance I participate on quality team and there are team reports that move both upstream and downstream, but since I am not the chair who delivers the reports I am unsure how the questions should be answered. 219The questions were quite vague and not clear. It seems more geared to management then bedside nursing220The role of a perinatal safety specialist is different from a perinatal educator 221The statements marked with me personally applying them every day apply to my practice. The ones that I don't apply in practice are because I'm not an educator or management designing protocols or policy and procedure. I'm strictly applying my own personal practice. 222The statements should be more concise. 223The task statements are a bit jargon filled and there is massive lap between domains224The task statements are very important. Unfortunately our institution needs to make qualtiy and safety a priority.225The unit I work is small, only 8 beds.226the vast majority of the previous questions is management related227Their is a large gap between my position as a staff nurse answer on these questions versus what the NICU manager might answer. 228There are items listed that I defined as important or very important that I don't participate in but happen regularly on my unit.229There are multiple areas where the task is important or very important but the frequency of performance is occasional or infrequent because they are large comprehensive projects and one cannot accomplish a large project every week. I'm not sure the scoring system is set to accomplish your goal.230These are wonderful goals. Was unsure if I was to answer about MY personal implementing/performing or my company's. If it is possible for me personally to do these measures, I typically do. I do not personally develop systematic processes that are developed and implemented within my professional team. That is a very difficult thing to establish within an organization; especially as a new employee. I am thrilled to see these goals begin to be established. As more people become aware of the importance we will be able to affect change.231These questions are a bit difficult to answer, because some of the frequencies are dependent upon the frequency of the events, not an actual periodization of events. 232These questions are quite skewed to the answers desired by the writers of this survey.233These questions are written in difficult to understand and complex language. They need to be written in simple, understandable language so as to be understood by anyone.234These questions were confusing to me. I wish the survey had used more plain language or provided examples. 235these seem to overlap a bit and are quite wordy... 236These seemed redundant and difficult to read. 237These statements are too general to determine what the question is really askin238These statements mostly don't apply to me and I don't really understand what they are regarding, to be completely honest.239These tasks are an integral part of our professional practice but it might not be me involved i all of them.240They seem redundant to me. 241This is a very comprehensive list and encompasses a lot of my role as unit manager. 242This is confusing. I am a staff nurse and all of these tasks are very important to my practice however it is Nursing Administration that has the authority to perform the tasks not staff nurses.243This is too long survey, fatigue sets in and you will not get correct answers 244This survey was so completely confusing. There were too many variables in each domain and task. I felt like some of each statement applied to me and my work and some did not, making it very difficult to answer the questions accurately.245Thorough and comprehensive with evidence of methodology to achieve objectives246Thru MoreOb program, our staff is consistently updated w/ evidence based practices, drills to maintain safety and accuracy, and inservices to insure competency. I may not be the nurse making others aware, but I do implement these into my practice.247Too complicated, became confusing248Too many barriers to mention here. As an educator I do my best. However, as an educator I am stuck between what I know is correct and susutainable with what is practiced. 249Too many questions and quite redundant. 250Too voluminous 251TThe statements are okay252Unit leadership and all staff have completed HRU training. This is referenced and reinforced frequently. Good catches as well as mistakes have become non-putative and safe practices continue to improve. 253Use of an EHR to maintain and sustain quality efforts254Validation of the adoption of EBP255very comprehensive256Very comprehensive.257Very Comprehensive.258Very good statements259Very vague. Hard to know whether to answer as me personally or as a unit as to what the normal practices are.260Very well stated,can‰??t think more add .261Very wordy262was there any "revaluation" of strategies263We attempted to implement supports to staff involved in an adverse outcome. Seniority prevailed and we were told we could not offer this to support staff as it violated union rules. . 264We have a KPI system where administration rounds to the individual units and reviews the daily data, as unit coordinator I supply the majority of the data. We had a horrible event happen related to an RCA and didn‰??t get a debriefing until 4 months later and it was very inadequate so would love to improve this area. 265We have a Quality Nurse in our NICU who is responsible for collecting data and investigating essays to improve quality. occasionally, we review literature on our own or identify problems/make suggestions for improvement. Our NICU also participates in Vermont Oxford collaborative to improve outcomes across the country. 266We have a quality task force which looks at any problems going on, comes up with a solution, implements it and monitors results continuously. We meet once a month.267We have a very organized team and meeting opportunity to perform these activities268We have had a formal safety program in place with skills drills and education called MORE OB which we have had since 2005. 269We have multidisciplinary approach to pt safety and QA. Meetings are at least mo nbn they and can be added o. To address urgent needs for change. Each discipline has input and participation in measures270We have Neonatal/Maternal QAPI (Quality Assurance Performance Improvements) every month to address all the above tasks.271we have no direction in evidence based care antepartum. intrapartum postpartum . our manager is incompetent and that is always a patient safety issue. The staff nurses know and do their job with confidence and sincere affection. but we are noticeably upset over the care we are forced to give. The experienced nurses are being forced to go either by firing them or subtle pushes to leave. not good for.the patients we leave and love272we participate in several VON initiatives and Solutions for Patient Safety273Whatever we are professional or not , safety is always a prioprity & that we have our licenses to protect.274While I have worked in OB for over 27 years, I am currently in a new organization. My answers would be different for my previous place of employment than currently. Some of that is because of how the organizations are run, but some of it is because I am newer and may not know all that is done behind the scenes.275While I understand the questions about the standards, it is a little unclear if the individual who is taking this survey is being asked if they think these issues are important or if the institution articulates and then carries through with the task statements. Quite often, there will be lip service paid to these standards but to the individuals who are not involved at the administrative level, if these standards are truly carried out may not be clear. If the second part of this survey was to determine if they felt that they personally did these tasks or if they felt the institution performs the tasks is unclear. 276Working in l&d, I find OBs do not want to change from their practice. This makes it difficult to incorporate evided based care. Even staff at my facility are unwilling to change or update their practice.277You lost me after the first few, this is a terrible survey & whomever designed it should be fired, instantly!278YOu used a lot of buzz words which lessen the clarity of what you are asking. Keep the politically correct verbiage and just speak clearly, And yes I do know what they all mean.279Your questions do not address how to implement best practices in community hospitals and physician organizations. This is lacking. 280Your survey making skills is horrible. The questions were too complex and too long. I had to read a book before getting to the actual questionAppendix SEQ Appendix \* ALPHABETIC F. Survey respondents’ comments about the major domains of practiceTable SEQ Table \* ARABIC 34. Survey respondents' comments about the major domains of practiceMAJOR DOMAINS OF PRACTICEIf you believe that there is a missing major domain of practice, please indicate the domain and associated tasks.Types of ResponsesNumber of ResponsesPercentage of ResponsesComments such as: None, Nothing to add, N/A, Nothing or none at this time, None missing, or "0"28767%Marks, such as "…" or "Xs"256%Comments11928%?Total431100%MAJOR DOMAINS OF PRACTICEIf you believe that there is a missing major domain of practice, please indicate the domain and associated tasks. Verbatim comments, N = 1191Accountability. Also physician non compliance for a safety culture is lacking in my hospital 2Action plans for integration and accountability, as well as sustainability take a very long time. I'm not sure this is adequately accounted for.3Again, contracted employees are often not involved in leadership or governance. Furthermore, the culture of an organization has to be open to involvement. 4Again, fire the person who designed this survey. I am deeply embarrassed to have an accreditation from NCC5Applying the guidelines to the bedside6Assist in establishing safe discharge plans for high risk families 7Believe there is a need for anonymous reporting of nurses bullying other nurses under the auspices of leadership and correction of errors in the unit, which is destroying our profession. Young nurses are fleeing mistreatment and lack of patience with ‰??training‰??.8better coordination between nurses and in our practice physicians9care of the staff; providing a non-toxic environment to work in10Caring for and managing critical infants majority of my time is clinical11Childbirth Education- Evaluation of effectiveness, review new recommendations & feedback from providers acted upon to improve how what we teach interfaces with actual practice.12clinical13Clinical documentation practice is key. Incorporating nursing standards of practice in to the EHR and extracting documentation metrics are key tasks for quality and safety 14Clinical Nurse Specialist and the MD's are more proficient IMPLEMENTORS of new or changing practice, although important to safe practice by the nurses, we are not the ones implementing.15Clinical patient care activity16Clinical practice is a priority and often requires canceling meetings resulting in delays in implementation and promotion of safety analyses. 17Common sense18Communication is an important safety factor19Concern of safe quality care over budget.20Connecting these domains to reality of clinical practice. Of course RNs rate these domains as important or very important. We KNOW it impacts patient care. Why are RNs leaving the bedside. Why do new grads not hang around? The ethical dissonance between what we know to be important and the one sliver of rightness we might be able to accomplish in a shift.21Continual Interdisciplinary Education of Quality and Safety components 22Continues improvement of the written medical record23Continuity of care.24Creating a culture of change25Data collection and reporting26Discharge planning complex neonate27Domain 4 evaluate the effectiveness of quality &safety practices in OB & Neonatal 28Drills29Educating novice staff is a routine part of practice that is not identified within those domains. Education is the foundation for safe practice and quality initiatives 30Education31Education of team members in the development and tools used in quality and safety initiatives 32End of life and palliative care practices 33ensuring availability of human and equipment resources and skill level to effectively meet safety standards34Established avenues in acute care facilities to do foster Nursing Research 35ethical and professional practice36Hands on teaching, simulations, using the safety tools with nursing staff.37How exactly does one change practice in a diverse a busy community hospital where best practices on paper are supported but no mechanism exists from a large group of diverse providers to. Change practice38I am quitting this survey. I am a PhD and I value research, but I think this survey is poorly written and difficult to apply, therefore I choose to not continue 39I believe the professionalism and ethical portion should be 100% always40I can't recall anything additional needed at this time 41I do no work in quality at all. I am a staff nurse and I work st night 42I don't think this percentage breakdown is very logical43I don‰??t 44I don‰??t think anything is missing45I think that continuing education and conference attendance for staff is essential in fostering an open-minded approach to practice. EBP buy-in is contagious, but NICUs that exist in a vacuum and do not expose their staff to other methods outside of a mandatory process that is introduced miss the opportunity to eliminate some barriers and identify those who will be catalysts for change.46I'm only a staff nurse, i do not develop or initiate anything.47if you know your job, then how you perform is key....regardless of the situation48Implementation of current evidence and best practice through appraisal of peer reviewed literature, systematic reviews, etc. 49Implementing and evaluating current best practices in high risk OB. Focus is s on budget with little consideration and following of best practice guidelines to promote improved patient outcomes and SAFE patient care. 50Implementing the practice at the bedside51Inclusion and recognition of the staff nurse perspective and the issues and challenges that arise at the level of the patient. The recent shift away from safety as a trump card and finance being the final say in all things has negatively impacted our work in significant ways52Incorporating patient assessed goals, culture and beliefs and assessment with the patient that they are met. Including rational, assessment and education. 53Incorporating patients into the equation. You have listed many admirable goals, but where are the patients? They are the center of my practice. How we interact with and empower our patients to make positive health care decisions for themselves is essential. You can have all the high tech, best practice, etc. interventions in the world but if the patients are not invested in their care then the results are less than they should be. Patient involvement in a collaborative approach, starting in the prenatal arena is a worthy goal. 54indvidual patient and family experience ( good or bad) that are truly measurable55Integrating family outcomes into everything we do56It appears that these domains are more appropriate for clinical educators or nurse managers. I am neither. I only work per diem, so I am not involved in governance committees or other leadership roles within the unit.57It was hard for me to place a percentage, as I feel everything is equally practiced. 58It‰??s not clear whether domain 3 means the nurse is working to get leadership on board with an initiative, or working *as* a leader to implement amongst staff. I spend more time on the latter. 59Language and cultural barriers60Leadership with knowledge and desire to improve maternal/child care at our facility.61less of nursing staffs62Lo63Maintaining clinical competency and promoting uptake of evidence-based practice with all members of the obstetrical and neonatal team.64Make sure recognized national and global initiatives are included to promote standardized practice that is evidence based. 65Management is responsible for these implementatipn66MD to get more education 67mentoring68Midwife at the bedside for care. Low dose pitocin practice 69More focus on safe staffing ratios70More hands on training that is paid time individually.71Most of these domains pertain to leadership/management positions, not direct patient caregivers.72Obstetrical and neonatal practice are totally different. They should be separated by practice measures. Maternal health indicators, Neonatal indicators etc. The successful measures used in one are not applicable to the other - and are sometimes in conflict, ie maternal health issues may drives premature delivery up. Prolonged neonatal hospitalization may drive maternal poor outcomes such as depression or PTSD measures. They need to be recognized as related but different. 73On question # 56: there are several committees working on these issues every month, therefore, it is not a question I am accurately answering, since more than 20% of each of these issues is addressed at least monthly. These committees are attended by nursing, neonatologists, and many other disciplines.74Pastier care as opposed to computer care.75Physician accountability related to nurse reporting substandard care to hospital and system wide standards.76Policies and protocols that are‰??physician‰??s discretion. This leads to too many rouge decisions and lack of safety. 77Positive reinforcement for jobs well done and retention of staff78Process improvement may fall under one of those domains but is a large bucket of work. 79Professional and ethical behavior by staff is generally a given, and less time needs to be spent reviewing or assuring that it is up to standard! More time can be spent on quality and safety of care issues.80Professionalism and ethical practice should be the umbrella that all QI/safety work is under. It cannot be a % of time spent.81Professionalism is always 100% the previous question implies that domain can not overlap with the other 4. Trying to apply a percentage for that domain is invalid.82Promote a safe and healthy work environment for staff nurses. Provide the resources and tools to allow nurses to perform their jobs well. Promote positive relationships and support from administration to staff nurses. 83Proper staffing allowances to enable interested staff perform these tasks without decreasing patient care staff84Provides appropriate and research based care to the patient. 85Quality initiatives are lacking as well as specific quality benchmarks that are distributed to those performing clinical work. 86Quality initiatives I am involved in are education.87Rarelis the prior done I this percentiles It is 10 % in most 88Research89Researching Best practices and bringing them in-house. All quality initiative don't have to emerge from ones practice environment.90Saving and evaluating practice statistics easily and electronically91see previous comment92Something that speaks to The Joint Commission's women's and children's cores measures, i.e. early elective delivery, exclusive breastfeeding rates, etc. should be mentioned. 93Staff competency and education94Staff competency? Physician engagement?95Staff development is a big part of my role.96Staffing 97Standards of practice 98Sustainability99Teaching, learning and sharing100teaching/ education of the patient in patient safety. 101TEAM Steps concepts and practice102Teamwork 103The disconnect between nurses and admin and how their micromanaging takes away from the best patient care and just continue to take away from that104The domains are good but with staffing the focus has been to do the work not examine how we can do better105The EMR - it affects so much time of nursing practice. 106The link between corporate philosophy and actual safety is nonexistent. 107There needs to be more focus on clinical practice at the bedside level108This is very difficult to quantify and I do not believe this survey will give you accurate data.109This survey is not appropriate for staff nurses I am not going to stop because I want you to know how inappropriate this survey is. It would be easier just to stop.110This survey is very vague and too complex111Tiring112Training in Lean six sigma for all practitioners, and development of a champion for safety culture. 113Vision for goals of unit and community feedback114We have to spend so much time with beaurcracy that we can‰??t spend time taking care of the patient anymore. 115We need more nurses and a longer surveillance time for mothers and babies. We are treating patients like they are a factory.116While ownership of a clinical practice, the birth center is a separate entity. Some of the domains cross over and create confusion in the answers117work-life balance workplace violence118yhe mds and providers need to find q place to regroup and make a special new land to make the future119You should use the term "maternity" instead of "obstetrics". Obstetrics is the domain of obstetricians, not nurses, midwives or family practice physicians. Appendix SEQ Appendix \* ALPHABETIC G. Knowledge statements: criticality validity scale – counts & percentagesTable SEQ Table \* ARABIC 35. Knowledge Statements – Criticality Rating Scale – Counts & PercentagesKnowledge Statements – Descriptive StatisticsK-#Knowledge StatementNot critical(0)Somewhat Critical(1)Critical (2)Very Critical(3)1Goals for health care quality improvement (e.g., STEEEP, IHI Triple aim)4249%130527%184038%130127%2Adverse events and event reporting (e.g., incident reports, near misses, root cause analyses)461%4098%180237%262554%3Institutional quality and safety processes and priorities (e.g., peer review, Just Culture, credentialing, goals)1012%74515%206943%195040%4Design assessment strategies (e.g., defining the population, assembling teams, literature reviews, measure identification, patient/family perspective)2706%130727%204442%125926%5Assess and maintain appropriate organizational culture and safety assessment (i.e., systems focus, level of Just culture)1273%91519%209243%174236%6Terms and definitions/common critical language (e.g., quality, patient safety concepts, quality improvement, organizational culture/unit culture, patient experience of care/satisfaction/participation/co-production, systems thinking).1423%93719%209143%170635%7General quality and safety principles.240%3417%186038%265354%8Awareness of legal/statutory and regulatory requirements, national quality and safety standards and clinical practice guidelines.491%64613%207042%211143%9Defining and understanding quality terms and concepts, data and quality metrics, identifying gaps in quality and safety, including the use of benchmarking and risk adjustment1844%108922%219245%141229%10Obstetric and neonatal resources for benchmarking best practice and outcomes591%48910%189939%243050%11Current professional standards and guidelines applicable to obstetric and neonatal care261%1824%135128%325068%12Current national, state, and regulatory standards and guidelines applicable to obstetric and neonatal care281%2625%155132%296262%13Methodologies of data display (e.g., run, control charts, pareto charts)79617%188039%142830%69214%14The concept of value as a function of quality and cost3988%175537%175837%88318%15How to implement and evaluate data collection strategies (e.g., checklists, process tools, huddle tools).3547%141529%187739%115724%16Human factors engineering (i.e., design of systems and processes).4319%141729%184738%111123%17Human psychology and cognition (e.g., situational awareness, violations of process/protocols, risk-taking, fear or repercussions, cognitive biases, attention and distractions, stress, burnout and fatigue).932%81917%195741%193540%18Safety climate, including safety briefings for staff, family involvement councils, quality and safety committees.701%54611%189539%229448%19Collaboration and effective communication strategies (i.e., handoffs, SBAR CUSS, debriefing, etc.)341%3678%162634%277658%20Understands next steps in advocating for system change when structured communications tools fail (e.g., chain of command; clinical escalation processes).701%60313%204543%208043%21Leadership skills (i.e., self-awareness/management; mentoring/sustainability/succession and transition planning; communication and conflict management).691%52011%187639%228748%22Teamwork concepts (i.e., team development, structure and function, diversity and inclusivity; collaboration, mutual respect, information diffusion; team meetings; code of conduct).361%2936%149131%292762%23Principles of teamwork and behaviors of effective teams391%3477%159634%276458%24Effective learning/teaching principles441%4489%194341%230149%25Use and principles of simulation, including unit drills involving simulated emergencies.631%53411%181038%233549%26Methods for determining human resource needs (e.g., hours per patient day, work hours per unit of service, work hours per birth, clinician to patient ratio, standards for staffing).3046%100921%178538%165035%27Process for escalating concerns about resource needs.1243%79017%202243%179738%28Issues that impact the work environment (e.g., the electronic medical record, medical devices, alarm fatigue, distractions, interruptions, overcrowding, noise, lighting, ergonomics of procedures, patient census and acuity).732%56512%186139%224747%29Dangers of workarounds.952%61513%182338%220747%30Relevant aspects of structural design standards.3918%146131%181938%106623%31Understand next step in advocating for system change when structured communications tools fail (e.g., chain of command, clinical escalation processes).812%77917%212845%170136%32Various methods for disseminating quality and safety data to various stakeholders (e.g., annual reports, presentations, publications, public reporting, including websites, social media, and other media)52711%148932%174837%92420%33Share data on key quality indicators with colleagues/organizations to improve transparency2666%122126%199042%120926%34Prioritizing the importance of individual opportunities for improvement1603%92320%217746%142830%35The importance of balancing measures3167%136929%196642%102722%36The difference between structural, process, and outcome measures4409%156033%178238%89219%37Process to develop goal statements for the metrics chosen54812%153933%172837%84818%38Similarities and differences between quality and safety improvement methods (e.g., PDSA/PDCA, Improve, Six Sigma, Lean, CUSP).71915%164535%152133%79517%39Team formation and dynamics (patient/family perspective, influencer model)2766%100421%195642%145531%40Evaluate and review various types of evidence related the quality and safety initiative and application to the population and setting.1934%103522%206144%139030%41Improvement process design (setting goals, benchmarks, thresholds and implementation plans)2586%118726%198443%120126%42Select, collect, track, and monitor appropriate measures/indicators (e.g., analysis, data definitions, visualization and interpretation) with consideration of reliability, validity and bias.3708%127027%186840%111724%43Medication, human milk, blood products, and nutritional safety (e.g., barcodes, e-prescribing, five rights of medication, EHR/ CPOE alarms and alerts).702%3548%147932%272659%44Risk reduction strategies (e.g. bundles, clinical pathways, quality guidelines)802%55012%180439%219147%45Error prevention strategies, (e.g., bundles, clinical pathways, quality guidelines).611%3959%165636%251054%46Auditing practices (e.g., feedback, surveillance).1734%110824%211746%122326%47How to display and interpret data (e.g., run charts, control charts, score cards)56012%165736%154833%85919%48Evaluation of outcomes and performance improvement1363%87619%207545%153833%49The role of technology in quality improvement1994%108523%207645%126327%50Define the value proposition in healthcare.56912%147132%166036%91320%51Evaluate patient/family experience.942%62714%172737%217047%52Distinguish between cost and value in healthcare.3057%134129%187941%109124%53Identification of waste in healthcare.2095%123027%188741%128028%54Cost (monetary and non-monetary).3017%129028%190041%111424%55Change theory.4339%149432%170837%96521%56How to implement and maintain a communication strategy that involves all stakeholders.2525%91920%193442%149933%57Recognition of threats to implementation and sustainability (e.g., fatigue, knowledge degradation, lack of upper level support/commitment, lack of team integrity, lack of personnel, competing priorities, lack of resources, disruptive behaviors, hierarchical professional behaviors).1002%59413%183540%208445%58Steps in project sustainment (celebration of success, modification of data collection and review).2886%115925%193442%122327%59Discern the relative strength of the design, source and methodology of new evidence and critical appraise the findings for use in practice (e.g., randomized trials, meta-analysis, expert opinion, observational studies, consensus documents).4089%138930%181039%99922%60Evaluate changes in key Federal statutes and regulations governing patient safety and quality that impact practice and guidelines.3037%113825%193542%122227%61The types of patient and provider protections that are regulated by respective states? statutes and regulations.3157%131029%182740%112825%62How variations in state law can have an impact on quality and safety activities.3267%125828%184540%114425%63Identify the elements of effective disclosure (e.g., disclosure of all harmful errors, explanation as to why error occurred, how effects will be minimized, steps to prevent recurrences, apology, acknowledgement of responsibility).1814%90220%202344%147132%64Distinguish between system error and human error identifying at risk and reckless behavior and respond differently/appropriately to each balancing no blame with accountability1102%62414%195643%188441%65Awareness of the differences between quality improvement projects and research.3929%137030%176339%104723%66Human subject protections related to quality and safety3277%108924%176038%139631%67Understand psychological harm experienced by the patient and second victims.2095%91920%181940%162336%68Understand the concept of the second victim.2936%113225%179539%134429%Appendix SEQ Appendix \* ALPHABETIC H. Survey respondents' comments about the knowledge statementsTable SEQ Table \* ARABIC 36. Survey respondents' comments about the knowledge statementsKNOWLEDGE STATEMENTSIf you have any comments about the comprehensiveness and/or accuracy of the knowledge statements, please enter them here. If you believe that there is a missing knowledge statement, please indicate the knowledge statement.Types of Responses# of ResponsesPercentage of ResponsesComments such as: None, Nothing to add, N/A, Nothing or none at this time, None missing, or "0"23271%Marks, such as "…" or "Xs"206%Comments7523%Total327100%KNOWLEDGE STATEMENTSIf you have any comments about the comprehensiveness and/or accuracy of the knowledge statements, please enter them here. If you believe that there is a missing knowledge statement, please indicate the knowledge statement. Verbatim comments, N = 751again option for important personally but not in current practice available with employer2again, excessive jargon just makes the whole field inaccessible to the practicing physician3Again, these questions use language that is not common to the normal person....as if they're trying to sound very important and/or intelligent. Please just write in a simple to understand manner that doesn't take 5 min. per question to figure out what is being asked.4All critical but the hospital institution does not provide funding for activities5All excellent questions. This all basically describes my job as Obstetric Patient Safety Officer for a medical system6All is well7All of these concepts are important but time to do these things are not incorporated into my clinical working hours. There is not time to do this 8As a CNS these questions are critical to run a high standard NICU 9As a staff nurse some do not apply directly 10As nurses and especially OB nurses, we must stay current to the jnformation and revulations set cor pracfice. We must also support each other11Communication between nurses medical team and administrators are inconsistent. There seems Tobe different rules for different team members 12Conflict resolution,grieving family13Cost and paying doctors for the time this takes in today's healthcare is NOT address as a doctor and MFM we are faced with more and more reporting regulations and codes in a complex system. Medical records are designed to bill we are paid by RVU. All this is important but you need to monetize improvement and participation by providers pay for education reward compliance. 14Design of this survey is faulty 15Don't know what a second victim is. Never heard of it. Is that the nurse?16Don‰??t know what you are speaking about here. You say this is about ‰?? obstetrical and Neonatal Quality and patient safety , but this is not for staff nurses and you should say that prior to asking a staff nurse to take your survey 17Education on expectations in Labor and Delivery, starting at antenatal appts can greatly impact patient/family experience & expectations 18Effective Communication 19Factors identified as risks affecting quality of care such as low staffing, lack of resources, no ability to effect a change to improve care due lack of control should be not only noted but then held accountable to quantifiable change.20Fully covered, difficult to answer as an educator and nursing malpractice expert21I am a staff nurse on my unit with extra responsibilities. Although I may not be performing all of these quality and safety evaluations and measure the effectiveness, it is communicated to the staff and we practice and perform what is expected of us and communicated to us22I am lucky to work in a health system with the resources to implement and evaluate quality and safety measures and the willingness to do so, and we have the outcomes as result. 23I cannot express enough, how little patient satisfaction should influence quality projects! 24I do not understand all the terminology you are using.25I felt that some of the questions were redundant. 26I have concerns that we end up being so focused on collecting data, interpreting and analysis, that we forget the prime reason for our existence which is to provide medical care. We are in danger of focusing on the data not the patient 27I have not clue what half (or more) of these things are. We use RCA, CUSS, LEAN and probably others at our small hospital but as a staff RN, we don't have any clue what managers do all day as we are sinking up on the floor. 28I think its difficult to balance everything stated here. They are all very important parts of the system but often our leaders are too spread thin to effectively use everything. Also budgets are so tight that teams are small and implementation of new practice, quality improvement, evaluations talked about here, is difficult and takes a long time. Finally I feel that many times we have reactionary solutions to problems and not proactively looking at problems. 29I think there should be knowledge statements about resiliency and helping staff return to a state of well-being after events.30I think using the term "critical" can be very subjective in these answers. Critical to me means life or death situtation and I am not sure that was the intention here.31I was not sure of some of the terms- unfamiliar terms such as‰??second victim‰?? would be helpful if defined32In previous leadership positions, I would have answered some of the questions differently.33it is a very long survey, I would not have started it if I realized there were this many questions34Management- evaluate the ability of management to participate and support the Q&A and willingness to participate in meetings, research and development of processes and staff education. I have found in my current environment that directions come downward without team participation and this affect support for and implementiation of directions given. I was told there is not a Unit Base Council anymore and when I participated in this and designs were created with staff involvement the improvements as directed flowed better and accepted because it was peer creation with management direction. As a charge nurse one must recognize the n Ed to be in teams.35may be break this into two sessions ...many questions time intensive 36more needs to be added about the second victim and the impact. Especially that the second victim is a victim too and need not be shunned the rest of his or her career.37Most of this is in higher level detail than I know. I participate in QI projects but my role is clinical. The terminology used is more academic, not that it was taught in my BSN or NNP programs 20+ years ago. 38My experience is a lot of work goes into process improvements but cost and control of those projects are always the reason those projects are able to sustain the work done.39National standards aren't always intuitive based on the evidence. There must be a better way to become aware of both. Also incentivizing adherence to new standards is difficult. Quality work must be its own reward, which many busy physicians don't want to do.40Need definition of terms..not all have been involved in QI/QA risk management etc41Not heard of the second victim42Not sure that I know or understand all the terminology of this assessment. 43Nothing missing all very important however administration doesn‰??t get it all hospital quality work is on pressure injuries caution etc need to expand quality agenda44patient and families are also critical ( essential) to the improvement processes45Patient experience should not be a benchmark. It dumps down our skills. Leadership is 100% focused on patient experience rather than safety. It‰??s disgusting and insulting to our practice. 46Please break it down in examples 47Quality and regulation is destroying healthcare. 48Quality/Safety is a separate role from risk management in my organization.49Really, I think all of this is bullshit. Doctors take care of patients and are best able to judge each other. EHR, protocols, order sets, hospital admin, hyper-empowered nurses all distract from that and lead to less safe care.50Really, you haven't fired the idiot who designed this survey yet??? Wow...there are no words. Go back to graduate school and stop wasting our time51research52Research and presentation at national and state level meetings53Safety protections and quality promotion initiatives may need to be separate54some of these I didn't even understand the question55The previous section contains important elements. However, they do not directly affect bedside care delivery, recognizing when your patient is deteriorating, what to do in those situations, etc. so don't really effect bedside RNs. Those issues are more related to management teams and upper leadership decisions that bedside staff are not privy to in general populations. I answered those questions as if I were the bedside RN and how important they would be for me to care for my patient.56The questions in this survey were difficult to understand, let alone answer with any accuracy. It sounds like something for a PhD program, not a staff nurse working with new moms and infants.57The questions seem to lack a community approach on things like SIDS reduction, breastfeeding rates, and access to care. I am curious if the emphasis on quality and safety is meant to be limited to the institutional setting.58The terminology in this survery is confusion, too similar making it hard to answer the questions. I am very clinical and work very little to no at all in quality59There are no items listed that are not critical however in viewing them from my specific role, some items are of less specific criticalness as I carry out my particular duties. In another role I would answer the questions very differently.60There should be a question if your hospital/NICU is part of the Vermont Oxford Network and a second question if you have participated in these research and quality improvement projects. I feel many of my answers are swayed because I am more familiar then some with these terms and use of research and quality methods61This are all extremely important in todays healthcare environment62This is a long survey (especially for a staff RN, answering after her 12 hour shift!). I notice I'm getting sloppier as I go along. I'd recommend breaking it into smaller chunks. 63This is a terrible survey Asks the same questions over and over. Of course all these aspects are important but you take an easy concept and make it too complex 64This is way too long!!!!!!!65This survey is too detailed and long should have done 2 surveys66This survey is tooo long67This was a bit over my head. I work in a tiny hospital. I care about quality a great deal. Some of these terms were foreign to me. It has been eye opening just taking the survey68This was obviously written by administrative/educational type people. Most of the questions are difficult to understand and have no relevance to normal practice. Speak English!69Too long, too wordy70Too long!!!71Unclear of questions 72Very thorough73Very well emphasized 74We teach the 6 rights of medication administration: Right patient 4. Right medication Right dose Right time Right route Right documentation 75You kinda lost me at Question 59. I have no idea what you are asking. ‰??With this knowledge...‰?? WHAT knowledge? You should probably throw my answers out because I answered not important at all if I really didn‰??t understand. Stupid question = ‰??eh‰?? is my answerAppendix SEQ Appendix \* ALPHABETIC I. Agenda for review of job analysis resultsNational Certification Corporation (NCC)Quality and Safety Sub-Specialty Certification Examination Job Analysis MeetingOctober 15, 2018AGENDA9:00 – 9:15 amWelcome and introductions9:15 - 9:30 amPurpose of the meeting and brief overview of work performed from February 2018 to present.Review of the job analysis survey results to finalize the content outline and test specifications for the examination.Development of the job analysis at the February 2018 meetingDevelopment of the job analysis surveyPilot test of the job analysis surveyDissemination of the surveyAnalysis and results9:30 – 10:00 amHow representative is the survey respondent group to the population?Overview of the survey response rate and completion ratesReview of demographic/background questions10:00 – 10:15 amBreak10:15 – 11:30 amComplete review of the demographic background questions.11:30 - 12:00 pmQualitative data review – Review of survey respondents’ comments concerning the comprehensiveness of the:DomainsTask StatementsKnowledge statementsIf necessary, refine content outline in response to comments.12:00 - 1:00 pmLunch1:00 - 1:30 pmComplete review of the qualitative data.1:30 – 2:30 pmQuantitative data review – Review of the validity rating scales’ descriptive statistics:DomainsTask StatementsKnowledge statementsIdentify decision rule to retain/remove statements based on the data to finalize the content outline.2:30 – 3:00 pmReview and finalization of preliminary test specifications If necessary, refine test specifications.3:00 – 3:15 pmBreak3:15 – 5:00 pm Complete review and finalization of preliminary test specifications If necessary, refine test specifications.5:00 pmMeeting adjourns for the dayAppendix SEQ Appendix \* ALPHABETIC J. Final content outlineNCC Obstetric and Neonatal Quality and Safety Sub-Specialty Certification ExaminationDomain 1: Systematically perform ongoing and comprehensive quality and safety assessment and gap analysesTASK 1.1 Systematically assesses the organization institutional and environmental culture, patient experience and outcomes, leadership and teamwork by using a variety of methods (e.g., surveys, direct observation and/or environmental scans, adverse events, system errors, and near misses) to identify gaps in quality and safety.TASK 1.2 Maintain current knowledge of national quality and safety standards and clinical guidelines from regulatory, accreditation, and specialty organizations, to promote ongoing change in practice to meet quality and safety indicators.TASK 1.3 Evaluate quality and safety metrics by analyzing baseline and ongoing data to determine current state of performance, identify gaps, and identify opportunities for improvement.Domain 2: Promote the integration of quality and safety practices within the organizationTASK 2.1 Incorporate quality and safety aims, tools, checklists and communication strategies into evidence-based projects to improve obstetric and neonatal care.TASK 2.2 Foster team function by integrating leadership and teamwork skills that empower members of the clinical team and improve communication to achieve a climate of safety.TASK 2.3 Educate and train obstetric and/or neonatal teams on quality and safety practices by conducting and debriefing team training exercises and implementing education using effective learning principles to improve task knowledge and optimize team functioning (e.g. mock codes, simulations).TASK 2.4 Advocate for ongoing resource needs by serving as a liaison for quality and safety matters between clinicians and administrators (e.g., participating in meetings, serving on committees and through risk assessment activities) to improve care and outcomes.TASK 2.5 Inform patients, colleagues, employers and the public about quality and safety initiatives/outcomes by disseminating outcome data, participating in benchmarking and publishing reports to maintain transparency.Domain 3: Develop and implement quality and safety initiatives in obstetric and neonatal practice.TASK 3.1 Select and monitor key quality metrics that assess a balanced set of quality and safety domains indicative of organizational culture and benchmarking.TASK 3.2 Apply recognized methods to design quality and safety initiatives in collaboration with necessary stakeholders (e.g., healthcare team, patients, and families) to identify the target population, measures (e.g., structure, process, outcomes) and data collection approaches to address identified opportunities.TASK 3.3 Integrate quality and safety practices into daily clinical workflow by using error prevention strategies, appropriate technology, and principles of high reliability to guide practice and improve outcomes.Domain 4: Evaluate and measure the effectiveness of quality and safety practices in obstetric and neonatal careTASK 4.1 Evaluate the implementation of quality improvement initiatives using relevant tools (e.g., fishbone, flow chart, run charts and control charts) to measure effectiveness of processes and outcomes.TASK 4.2 Articulate the value of specific obstetric and neonatal quality initiatives by evaluating the balance between quality, outcome and cost, including the perspectives of all stakeholders (e.g., healthcare team, patients, and families).TASK 4.3 Identify strategies of moving quality improvement initiatives into sustainment in order to maintain positive change in an overall obstetric and neonatal quality and safety program.Domain 5: Professionalism and ethical practiceTASK 5.1 Provide support to patients, families and staff following an adverse event, implementing appropriate and standardized processes to disclose adverse events, minimize negative psychosocial consequences and promote transparency, patient trust and risk mitigation. TASK 5.2 Demonstrate professionalism by applying ethical principles (e.g., fairness, truthfulness, justice, beneficence, nonmaleficence, autonomy) relevant to patient safety and quality activities (e.g., RCA, disclosure) to maintain personal and institutional integrity and to foster a culture of safety and organizational excellence.Knowledge Statements:Goals for health care quality improvement (e.g., STEEEP, IHI Triple aim)Adverse events and event reporting (e.g., incident reports, near misses, root cause analyses)Institutional quality and safety processes and priorities (e.g., peer review, Just Culture, credentialing, goals)Design assessment strategies (e.g., defining the population, assembling teams, literature reviews, measure identification, patient/family perspective)Assess and maintain appropriate organizational culture and safety assessment (i.e., systems focus, level of Just culture)Terms and definitions/common critical language (e.g., quality, patient safety concepts, quality improvement, organizational culture/unit culture, patient experience of care/satisfaction/participation/co-production, systems thinking).General quality and safety principles.Awareness of legal/statutory and regulatory requirements, national quality and safety standards and clinical practice guidelines.Defining and understanding quality terms and concepts, data and quality metrics, identifying gaps in quality and safety, including the use of benchmarking and risk adjustmentObstetric and neonatal resources for benchmarking best practice and outcomesCurrent professional standards and guidelines applicable to obstetric and neonatal careCurrent national, state, and regulatory standards and guidelines applicable to obstetric and neonatal careMethodologies of data display (e.g., run, control charts, pareto charts)The concept of value as a function of quality and costHow to implement and evaluate data collection strategies (e.g., checklists, process tools, huddle tools).Human factors engineering (i.e., design of systems and processes).Human psychology and cognition (e.g., situational awareness, violations of process/protocols, risk-taking, fear or repercussions, cognitive biases, attention and distractions, stress, burnout and fatigue).Safety climate, including safety briefings for staff, family involvement councils, quality and safety committees.Collaboration and effective communication strategies (i.e., handoffs, SBAR CUSS, debriefing, etc.)Understands next steps in advocating for system change when structured communications tools fail (e.g., chain of command; clinical escalation processes).Leadership skills (i.e., self-awareness/management; mentoring/sustainability/succession and transition planning; communication and conflict management).Teamwork concepts (i.e., team development, structure and function, diversity and inclusivity; collaboration, mutual respect, information diffusion; team meetings; code of conduct).Principles of teamwork and behaviors of effective teamsEffective learning/teaching principlesUse and principles of simulation, including unit drills involving simulated emergencies.Methods for determining human resource needs (e.g., hours per patient day, work hours per unit of service, work hours per birth, clinician to patient ratio, standards for staffing).Process for escalating concerns about resource needs.Issues that impact the work environment (e.g., the electronic medical record, medical devices, alarm fatigue, distractions, interruptions, overcrowding, noise, lighting, ergonomics of procedures, patient census and acuity).Dangers of workarounds.Relevant aspects of structural design standards.Understand next step in advocating for system change when structured communications tools fail (e.g., chain of command, clinical escalation processes).Various methods (e.g., annual reports, presentations, publications, public reporting, including websites, social media, and other media) for educating and disseminating quality and safety data to various stakeholders Share data on key quality indicators with colleagues, organizations, patients and families to improve transparencyPrioritizing the importance of individual opportunities for improvementThe importance of balancing measuresThe difference between structural, process, and outcome measuresProcess to develop goal statements for the metrics chosenSimilarities and differences between quality and safety improvement methods (e.g., PDSA/PDCA, Improve, Six Sigma, Lean, CUSP).Team formation and dynamics (patient/family perspective, influencer model)Evaluate and review various types of evidence related the quality and safety initiative and application to the population and setting.Improvement process design (setting goals, benchmarks, thresholds and implementation plans)Select, collect, track, and monitor appropriate measures/indicators (e.g., analysis, data definitions, visualization and interpretation) with consideration of reliability, validity and bias.Medication, human milk, blood products, and nutritional safety (e.g., barcodes, e-prescribing, five rights of medication, EHR/ CPOE alarms and alerts).Risk reduction strategies (e.g. bundles, clinical pathways, quality guidelines)Error prevention strategies, (e.g., bundles, clinical pathways, quality guidelines).Auditing practices (e.g., feedback, surveillance).How to display and interpret data (e.g., run charts, control charts, score cards)Evaluation of outcomes and performance improvementThe role of technology in quality improvementDefine the value proposition in healthcare.Evaluate patient/family experience.Distinguish between cost and value in healthcare.Identification of waste in healthcare.Cost (monetary and non-monetary).Change theory.How to implement and maintain a communication strategy that involves all stakeholders.Recognition of threats to implementation and sustainability (e.g., fatigue, knowledge degradation, lack of upper level support/commitment, lack of team integrity, lack of personnel, competing priorities, lack of resources, disruptive behaviors, hierarchical professional behaviors).Steps in project sustainment (celebration of success, modification of data collection and review).Discern the relative strength of the design, source and methodology of new evidence and critical appraise the findings for use in practice (e.g., randomized trials, meta-analysis, expert opinion, observational studies, consensus documents).Identify the elements of effective disclosure (e.g., disclosure of all harmful errors, explanation as to why error occurred, how effects will be minimized, steps to prevent recurrences, apology, acknowledgement of responsibility).Distinguish between system error and human error identifying at risk and reckless behavior and respond differently/appropriately to each balancing “no blame” with accountabilityAwareness of the differences between quality improvement projects and research.Human subject protections related to quality and safetyUnderstand and mitigate psychological harm experienced by the patient and second victims.Knowledge of ethical principles as they apply to patients, families, providers, and organizations. Appendix SEQ Appendix \* ALPHABETIC K. Survey respondents’ comments about eligibility requirementsTable SEQ Table \* ARABIC 37. Survey respondents’ comments about eligibility requirementsWhich of the following minimum eligibility requirements to take this examination would be necessary to achieve competence in quality and safety specialty practice? OTHER (PLEASE SPECIFY) VERBATIM RESPONSES1?210 years 310 years experience minimum, you don't know what you don't know410 yrs of experience minimum...probably hard to do 52 or more years of experience62 year experience, N = 372 years experience and licensure82 years experience in the area of OB quality/safety92 years experience working in a unit real world 102 years in specialty112 years obstetric experience122 years of experience 132 years of working in the field 142 years practice in OB or NICU as RN152 yrs experience 162-3 years of pratice172-4 YEARS OF WORKING IN SPECIALTY AREA182000 hours experience in said area 192000 hours in the last 3 years202000 hours working in clinical setting212500 hours223 years full time 233 years work experience 243-5 years experience253-5 years of clinical experience to get to the Competent to Expert Level in Patricia Benner‰??s Model.263+ years of active practice274 year applicable degrees 284 years experience in OB/Nursery. If not specific for OB then 4 years of full time nursing experience. 295 years at the bedside to get a minimum understanding of what happens in real life305 years clinical experience315 years experience 325 years experience in clinical area335 years in current profession, ability to show proof that quality and safety are already part of a job. Competence in passing a test isn't equivalent to competence in performing the role requirements. Sometimes, having the credentials aren't the same as being competent.345 years minimum practice in specialty area355 YEARS OBSTETRICAL EXPERIENCE 365 years of experience in field375 years of experience in said area of specialty practice385 years of in field experience395 years of practt405 years of relevant practice.415-10 years of current practice 42500 hours of clinical practice each year and current license in US or Canada43A, N =244A minimum of 5 years clinical experience in specific field. 45A minimum of 5 years experience in OB/NICU- patient care experience46Actively work in research or leadership/education position 47actively working in maternal child health area48Advanced degree. Several years experience in clinical setting. Certified by NCC. 49Advanced education, an interest in this subspecialty and several years of experience.50All nurses51Any Registered Nurses International 52associate degree in nursing53Associate Degree with at least 5 years experience 54At 55At least 2 years experience 56At least 2 years of experience in the Maternal Child area.57at least 2 years of work in this field, similar to the other certifications; at least 50% of their time in education/quality and safety58At least 2-5 years experience in this specialty59At least 3 years experience60At least 3 years in speciality area61at least 3 yrs experience62At least 5 years clinical practice and 2 years leadership/quality/education63at least 5 years experience in the field64At least 5 years in specialty with 3 being in Education or Perinatal Safety/Quality65At least 5 years of clinical experience66at least 5 years work experience in a labor and delivery setting67At least 5 years working in Obstetrics68At least a BS or BSN degree.69At least a BSN70At least a Master's degree. I am not sure if undergraduate education would provide enough base education71At least five years in specialty and two in leadership within specialty 72At least one year experience in quality73At least one year of full time work in a quality improvement, safety or evidence-based practice department.74At least three years clinical practice in OB/Neonatal setting75B76Bachelor- has had courses on research and stats77Bachelor's degree minimum78Bachelors degree79Bachelors degree and currently licensed in the US or Canada80bachelors prepared and beyond81Bachelors preppared RRT with NPS82Background in management, quality.83Be part of some initiative safety and quality group or comitee, perform audits etc...84Bedside clinical experience- minimum 3 years85Board Certification86Board certified in a relevant specisltu87Board verification in OB or neonatology88BS or above89BSN, N = 2190BSN and 20 CEs specific to quality and safety91BSN and 5 yrs experience92BSN and job in the field93BSN and RNC94BSN currently licensed in the US 95BSN degree (BS in NURSING), currently licensed in US or Canada, green belt or higher in Six Sigma Certification96bsn minimal97BSN OR above98BSN or higher99BSN or higher Minimum 5 years of practice100BSN OR MSN101BSN or MSN102BSN with administration experience.103BSN, RN minimum Working in nursing education/ administration to be able to appreciate/ understand the content104Certain amount of work experience within a hospital or healthcare setting- in a roll that involved leadership 105certain number of years in current practice106CERTAIN NUMBER OF YEARS OR HRS WITHIN THE LABOR AND DELIVERY SETTING107Certification as NRP instructor.108Certification in Lean Six Sigma109Certification in neonatal or OB care110Certification in ob111Certification in OB, NICU, or POSTPARTUM CARE as a foundation to then build into a quality and safety cert 112Certification in specility113Certification on specialty field114Certified in NCC specialty 115Certified in specialty area 116CEU specific to this area117Clinical certification in either NICU or OB118Come on, you guys must know this is bullshit.119Concurrent NCC accreditation in the field, such as; I have my RNC-OB, and then I could pursue an RNC-OBSQ (Safety and Quality). 120Course to update knowledge121Creditialed by NCC in specialty. This is a sub specialty credential122Current Certification in OB, MNN or practiced in the area for a minimum number of years. 123current core certification124Current license and 3-5 years experience on the floor.125Current license and a minimum of two years working in Maternal Child Nursing and/or Patient Safety.126Current license and atleast 5 years experience 127Current license and experience128Current license and minimum experience criteria.129Current license and minimum hours of experience in field.130Current license and over 2 years in clinical practice131Current license AND the IHI certification132Current license and work experience in the field at the bedside133Current license in the U.S. or Canada AND at least a few years of work experience in the OB/Neonatal quality/safety space. Quality/Safety certification would require more than just studying for the exam. e.g. Knowing when to use a fishbone diagram is good. Knowing how to MAKE a fishbone diagram would be an expectation for certification.134Current license in US and 2 years work experience in obstetric or neonatal care.135Current license, possible number of years working136Current license, several (2-4) years working in the specialty, 137current licensed in US and work in OB/Neonatal area for a minimum of 5 years138Current licensure and minimum of one year experience in quality and safety practice. 139current licensure, 2 years in current specialty area, BSN as minimum ed requirement140Current licensure, a training course and additional self-study CEUs. If it's a title that is supposed to earn any respect, there better be more to it than a multiple choice test!!! I sincerely hope NCC is not writing tests with bogus titles to get more test-fee money. 141Current NCC specialty certification 142Current RN license with minimum of bachelors degree, Masters preferred.143Current specialty certification. 144Current valid licensure as well as at least 2-4 years experience with Quality Initiatives and/or data collection. The candidate must demonstrate a working knowledge of this area of certification.145Currently in a team leader/management role in ob/neonatal are a/plus current licensure in US/Canada146Currently licensed + minimum years of experience in a patient safety role in Obstetrics or Neonatal safety, such as 2 years147Currently licensed along with at least one year of clinical specialty bedside practice within three years immediately prior to applying for exam eligibility148currently licensed and practicing in quality and safety in some role149Currently licensed in the US and Canada and Bachelors prepared. 150Currently licensed in the US and Canada, Minimum BSN, greater then 3 years working in a position which regularly incorporates quality and safety measure development, implementation and evaluation151Currently licensed in the US or Canada Minimum of 2 years of experience in a position that implements and measures quality and safety: CNS, educator, clinical nurse on a quality and safety team. 152Currently licensed in the US or Canada and knowledgeable in the specialty with at least 2 years working in the specialty.153Currently licensed in the US or Canada and minimum of one year of full-time experience in Obstetric or Neonatal practice.154Currently licensed in the US or Canada and prepared at least at the baccalaureate level155Currently licensed in the US or Canada for a minimum of 2 years.156Currently licensed in the US. 2 years of practice on OB/Neonatal157Currently licensed in US or Canada and minimum 1 year relevant experience.158currently licensed or legally recognized, such as certification. Not all quality specialists have a license, nor do all providers. For example, in Missouri a CPM may practice midwifery but does not hold a state license159Currently licensed with specific number of years of related experience and specific minimum education level160Currently licensed, MSN or higher, minimum number of hours worked as a RN in either Obstetrics or Neonatal Nursing 161Degree in Quality and Safety management162demonstration of application of QA and safety practice as part of current function and practice163DNP164Do not know165Each year as a clinician we have to take more than 50 all kinds of examinations and another more than 40 examinations for research work. Don't we have enough examination to ruin our life? 166Either a letter of recommendations or approval from manager for appropriate number of hours completed in this field167Experience and licensed168experience in both perinatal nursing and quality. 169Experience in field (2 years)170experience in management or quality/safety role171Experience in the specialty172Experience with quality teams; or in quality department 173Five years of bedside nursing174Formal education regarding quality and safety strategies 175further study to improve comprehension?176Graduate degree177Have been a RN for 2 years or greater178having taken a specific quality/safety related course179History of work in the area of obstetrics and newborn care.180hours worked in a quality and safety role, similar to other certification requirements181I, N =3182I believe at least a bachelor's degree should be required.183I can't answer answer this question184I do not know, N = 2185I don't know why you would require licensure, limits the pool186I don't understand the question187I feel that you need to be working in that speciality of a risk manager or a manager to be licensed in this. A staff nurse who does patient care does is really the end user of the information that is given to them by leadership who are involved in the safety initiatives.188I feel you should already hold a prior certification. For example RNC Inpatient OB; in addition to current license. 189I have no idea190I keep clicking currently licensed in the US but it switches to other 191I really dont know, maybe a certain number of CEUs?192I think a lot of those themes are specific to what I learned in my advanced degree. People would need some basic safety courses193I think we must have some clinical practice in this area. Attend meeting. Spend time on committees. Evaluate data. 194I think you should also hold either the NICU or OB NCC certification - how can you be an expert in the safety/workings of either specialty if you don't have a firm understanding of the medical/nursing side?195I would open this for all clinicians (Not only MD's and DO's) working in these disciplines as Quality and Safety is truely an interprofessional activity196I‰??m 197Ij198In addition to current licensure there should be a minimum number of hours or years of experience. One cannot demonstrate competency if they‰??ve had no time to do such.199In addition to licensure, a minimum level of experience in the area of practice200In addition to US: Canada license. Hours of practice and higher level of education 201In patient OB.202In practice for at least one year203In the US, I believe that it should only be available to those with a minimum of a Bachelor's Degree204J, N = 3205Knowledge of EBP and how to implement it in a clinical setting. 206License and evidence of participation/experience in quality improvement wctivities207license and greater than one year in specialty208License in US or Canada & 5 years experience in Perinatal or Neonatal nursing 209License, 2-3 years experience210license.+5years experience.211Licensed and at least 5-10 years in practice.212licensed and should have advanced degree213Licensed in the US214Licensed, but also so many hours already working with a process improvement/safety project. 215Licensing in US or Canada and minimum of 3 years of practice in perinatal or neonatal practice. 216Licensing plus related work experience and a higher level of education 217Licensure along with some experience with quality and safety practice.218Licensure in US or Canada along with XX years of leadership (educator, manager, etc)experience in Neonatal field particularly in level III or IV NICU219M220management experience221Masters and advanced practice NP222Masters degree, N = 4223Masters Degree that is NON-entry level. Masters prepared Educator or Clinical Nurse Specialist224Masters Degree, Minimum hours working in this field225Masters in nursing or masters in business226Masters in Nursing, or Masters in Public Health -- in addition to currently licensed in US or Canada227Masters or greater and current job role in the areas of quality, safety, risk management, nursing administration, nursing education.228Masters prepared experience in this field229Maybe hold another certification as well230minimum 10 years of active community practice231Minimum 2 years work experience in OB and Neonatal Quality and Safety realm and/or leadership role232Minimum 5 years experience in clinical practice233Minimum 5 years experience. 234Minimum 5 years in a quality or leadership position and/or MSN235Minimum ban butshould be msn or dnp236minimum five years experience in OB/Neonatal237Minimum hours working in sub speciality238Minimum number of courses that cover relevant subjects necessary to perform role in Quality and Patient Safety239Minimum number of years in the specialty. Active experience in quality and safety measures. 240Minimum number of years practicing in respective field.241Minimum number of years working in obstetrics, i.e., two year minimum.242Minimum number years experience working in safety and quality 243minimum of 2 years acute care experience244Minimum of 2 years experience in OB/Neonatal nursing245Minimum of 2 years experience in the specialty246Minimum of 2000 clinical practice hours247Minimum of 5 years in clinical practice248minimum practice years249Minimum work requirements/time in practice (ie 1000hours)250Minimum years of experience251Minimum years worked in Neonatal? 5+ - licensed in US or Canada would go with that as well. But licensed as what? RN? RT? MD?252Minimum years/hours of professional practice 253MINIMUM: Master Science in Nursing or an equivalent degree254MSN, N = 8255MSN & with clinical experience as RN256MSN but Doctorate level preferred257MSN required and at least 5 yrs experience in acute care258N/A, N = 9259NCC certification in an additional specialty260NCC Inpatient OB or NICU261Need to have worked in quality improvement area for at least one year or have master's degree262Needed to remain educational in our field.263Neonatal or obstetrical certification. 264No idea at all265No opinion266not sure, N = 2 267None 268Not necessary at all269Not sure what the requirements are270Number of hours in specialty or in good standing credentials such as inpatient, high risk, neonatal certs 271Number of hours worked in specialty272Nurse that has worked a minimum of 5 years in the OB specialty and has experience in 3 areas of OB practice, L&D, PP, Newborn, office, research, birth center, multi levels of care, Level 1 through Level V as all have unique aspects that need to be addressed when identifying quality and safety. OB often lives in a small protected world as nurses and providers do not move in and out of the specialty and do not move through institutions in many cases so the world they know is very small. We need to look at what works and why. Who has the lowest C/S rate, what are they doing different than the highest level. We are not good at making the mother responsible for decisions, well informed decisions, information without bias, 'your baby will DIE', information. 273Nursing physician and midwifery274nursing degree minimum BS/BA275O276OB work experience277Obstetric or Neonatal experience278Of course Registered Nurse licensure and a minimum number of actively working in the field.279One year experience in clinical setting in OB and Neonatal nursing .280Other obstetric certification281P282Participation in quality and safety areas I practice283Participation in quality and safety initiatives, and membership in a multi-organization collective of reporting, tracking, benchmarking, and setting standards for specialty practice.284Participation in quality and safety initiatives. How many? What types? 285Participation in quality and safety project as a team member. 286Please make someone either hold a job in QI, or display a QI project they completed discussing methodology with measures to view. Don‰??t water down the certification. Proof of PDSA ramps knowledge and application.287Post masters certification in quality and safety or doctorate288Practice in an advanced role for several years289Practice in speciality for more then 5 years 290Proof of some formal training in quality and safety whether through an employer or a certification program.291Proof of working in this specialty 292Proven hours in pt safety- quality or risk management 293Relevant work experience, including work in clinical setting294RN BSN295RN in specialty 296RN, experience in QI and risk management of 3 years minimum. Other specialty areas should be increased to 5 years as we are producing NOVICE advanced providers which is watering down level of experience and respect in medical arena.297RNC 298RNC in either Obstetrics or Neonatal Nursing required, also set a limit on years of experience necessary (maybe 5 years)299RNC in their area300RNC inpatient OB301RNC-OB302RNC-you should be credentialed in your field of practice before getting this type of credential303Serve on a quality and safety committee in your workplace304Set amount of practice time in the obstetric arena (no less that 3 years) 305several years experience in field and certification in speciality306Several years or hours of practice in the field307should also include some experience in the practice area - similar to current expectations - not necessarily a quality and safety role, but experience in an applicable practice area308Should have worked in a specialty area for a predetermined period of time before taking the exam.309So many hours in obstetrics or neonatal specialty310Some advanced practice role311Some experience in the area 312Some pre-determined experience in Quality and Safety processes.313Some sort of practice requirement. 314Some type of clinical practice in case or policy review. 315Specially license in practice field Certification in advanced practice Ongoing education in specialty field of practice 316specialty education (i.e. LEAN) or evidence of knowledge application x 1 year317Specific number of hours working in the area other than as a staff nurse318specific number of years of experience in specialty practice319SUFFICIENT EXPERIENCE IN OB. 320There must be a minimum number of hours in the specialty to take this exam. Perhaps 2000321there should be a predetermined number of years in the clinical area. It would seem that until you work in the clinical setting you are simply learning for a test, you have no frame of reference to work with.322This should be a certification or class required of every Fellowship program in the country in OB and NICU. 323Training, team building and continuing education throughbpost training mentorship.324Two years experience325Two years experience related to the maternal and/or newborn areas326Two years in a row that uses these skills-- unit manager, quality manager, educator, patient safety officer etc AND RN 327Two years of experience in L&D high risk antenatal 328U329Unknown, N = 2330unsure331Us & Canada license332us citizen333V334Verification of participation in quality and safety by manager/employer335Why can we not select currently licensed and something else? I believe there should be a minimum of BSN.336Work experience 2-5 years in specialty area.337Work experience in Perinatal nursing 338work in OB for at least a year339Work in quality and safety for 2 years340Working as a charge nurse 341Working in a quality role for 2 years at least 342working on efforts that employ these strategies/concepts on a daily basis for at least 2 years343Worldwide 344Would suggest current professional licensure AND current board certification in a pediatric/neonatal subspecialty in order to demonstrate proficiency in basic clinical knowledge before one embarks upon improvement measures. You can‰??t improve what you do not understand.345X346Year of OB leadership experience 347Years experience in nurse profession and involvement in quality organization/projects348years of experience349Years of experience in ob350Years of experience in the feild351Years of practice experience352Years of practice in that field.353Years of relevant nursing experience 354Yes to the currently licensed....but also would think you would need some background in QI and Safety to pass a certification exam. Not sure a new nurse would understand QI principles unless unit was heavy into QI.355You must set some experience requirement eg. 3 years in a clinical practice356ZAppendix SEQ Appendix \* ALPHABETIC L. Survey respondents’ comments about continuing education requirementsTable SEQ Table \* ARABIC 38. Survey respondents’ comments about continuing education requirementsWhich of the following continuing education requirements to maintain the credential would be necessary to achieve competence in quality and safety specialty practice? Other (please specify) VERBATIM RESPONSES1528310, N = 6420525630, N = 5735, N = 2845, N = 39 20 plus CE’s every three years specific to quality and safety.10?, N = 211.12.......to stay current , I have to have 45 CEs every 3 years1310 as above1410 CE, N = 81510 ce’s Because the reality of getting them is harder than others1610 CEs if already have one certification 1710 CES unless administrator 1810 CEUs every 3 years1910 CME every 2 years2010 specific to quality and safety with more related to clinically specific ces2115 ce every 3 years is fine but in a course that is free and short(1-2hours). 2215 CE every 4yrs as you will have to maintain another RNC specialty2315 CE is excessive given other certifications also require 10 or so every 2-3 years. To be certified in several entities ends up being a burden. 2415 CE's & an outline of a quality or safety initiative addressed during the 3 year re-cert period. 2515 CE's every three years specific to quality and safety seems appropriate but may be burdensome to those already certified in another specialty (ie: RNC-OB)2615 ce‰??s Q 3 yrs2715 CE‰??s very 3 years and a minimum of 45 hours direct work 2815 CEs annually2915 CEs annually specific to quality and safety.3015 CEs every 5 years3115 CEs every three years specific to quality and safety AND submission of a "report" on a recent (past three years) or current improvement project in the area of OB/Neonatal care. NCC would provide template. 3215 CEs with no other NCC certifications. With other NCC certifications this number should be reduced.3315 CEs yearly3415 CEU's of your choice, not ones we have to purchase from you so you can make more $ to design crappy surveys like this one3515 ceus in area of specialty3615 in either neonatal or obstetric specialty3715 is a little excessive3815 is fine, however if you hold other certs in this area, make lessening the amount in each. 392 CEUs q 3 years4020 CEs every 3 yrs4120 CEs every three years specific to quality and safety4220 CEU's4320 every 5 years4425 CEs every three years specific to quality and safety4525 ceu q3 yrs4625-304730 CE every 2 years4830 CE's every three years with a minimum of 5 reflecting communication strategies4930 ce/3 years 5030 CEs5130 CEs5230 CEs every 2 years specific to quality and safety in Obstetrics and Neonatal combined (15 in obstetrics and 15 in neonatal).5330 CEs every three years specific to quality and safety5430 CEU's every 3 years5530 CEUs specific to quality and safety every 3 years 5630 every 2 years, just like other certifications.5730 every 3 years5830 every three years5930CE's604 ce‰??s6140 CE's every 3 years6240 hrs6340-60 points every 10 years6445 CEs6545 CEs6645 CEs6745 CEs every 3 years6845 CEs every 3 years specific to quality and safety6945 ceu every 3 years7045 CEUs7145 CEUs q three years7245 credit hours, like most specialty certification.7345 credits every three years. 7445 RNC 755 CE765 ce's every 3 years775 CE's specific to patient safety and quality. 785 CEs795 CEs as these are harder to obtain805 CEs every 3 years to specific to quality and safety815 CEU's every 3 years825 is enough835 is minimum i think845-10 CME credits in 3 yrs.855-10. Most likely someone with this credential would already be trying to get credentials for another certification.8650 CE s every three years and via exam every 6 years.8750 CEs every three years8850 yearly cat 18955 CEs every 3 years905CEs915CEs925ceus935CEUs is plenty for the poor soul who chooses this specialty947 CEUS / year.958 CEs EVERY THREE YEARS968 per year if this is additional RNC (most positions can't afford original 15 plus another 15 annually to maintain 2 certifications) 15 per year if only RNC for 45 to renew q 3978ceu98A99A free refresher update as evidence based information becomes available. 100Abstract/poster presentation 101Active employment.102Again,do not know what the requirements are103An exam to determine the areas to focus and the appropriate CEU's in that domain. 104Annual competency assessment in quality and safety105As many CEs as the inpatient OB every 3 years106As minimal as possible and allow a wide range of CEU‰??s from other sources to count 107Assessment and cues as applied108at least 10 CEUs per year109At least 15110CE will not fix this. We already have to maintain creditials111CE's are great, but a portfolio of projects would be an amazing demonstration of continued work and development in the role. 112CE's are important but not sure 15 is the magic number, should include opportunity to substantiate education through work product as well, re: adult learners don't learn best by didactic education113CE's but only one or two per year.114Ce‰??s Plus proof of involvement at some level in a quality project115CEs could also be specific to OB- example: Simulation, legislation116CEs OR portfolio of verified quality and safety related experiences / leadership / etc for the certification period117CEU covered payments by institution118CEU's or demonstration of quality initiative development, initiation and evaluation. I would not want to see this another certification that feels like a money grab for CEU's119CEUs or ongoing professional education such as college classes etc.120CEUs plus continuing to work in the specialty. (some people get a certification but do not work it, they just keep renewing credentials to "look impressive)121CEUs provided by your employer by attending a class within the organization to maintain standards and inform of changes in guidelines within the organization... talking the same language. RNs, MDs and management122CME 123Combo of CEs or evidence of work on quality and safety teams, such as the NY State Collaborative projects. 124Completion of at least one project every three years125Continued employment in the field. Paying a fee. No more testing. Not 45 CEUs. It‰??s too much for full time. 126Continuing education and mentorship every year.127Continuing education offered by the institution you practice.128Credentialed in Inpatient OB and EFM129Current license and experience130Current participation in you facilities quality improvement team with evidence of current QA/QI projects and results.131Demonstrated competence and involvement132Do not know 133Documentation of ongoing projects or proof of engagement 134Don't know135Don't really think education credentials would be needed136Don‰??t know 137Don‰??t make physicians life harder138Dual credit from ACOG, AAFP, AAP139Due to the cost of CME's and the need to maintain other credentials I would encourage fewer CME's and broaden the type of CME's to include Leadership programsfor example.140Every OB and NICU physician should be required to take ongoing CME credits in this area as part of maintenance of certification. 141Examples of current work in the field. Portfolio 142Examples of leadership in Quality and Safety initiatives in practice143Explore opportunities for those certified to demonstrate their expertise, e.g., peer reviews144For RT - match it with the NPS or ACCS - 6 years correct?145Here we go! More money.146Hey 147I, N = 3148I am not certain149I am not sure150I believe 15 CEUs in quality and safety is too high. This credentialing needs to remain focused on knowledge in nursing to care for patients at the bedside. This basic knowledge seems to be slipping more and more and RNs do not recognize deteriorating patients. If you feel the need to have an additional Certification exam specifically in nothing but Quality and Safety nursing then 15 is fine. For regular floor nurses they should be focusing on remembering A&P and specific situations to their areas of expertise.151I do not know, N = 3152I do not know that 15 CE in this area are available to be had at this point in time.153I don't understand the question154I have my RNC155I only need the minimum CEs156I see a problem with CEs frequently not being offered for many QI/Safety meetings, webinars etc. 157I think 15 continuing education hours is low over 3 years.158I think CE's are a good idea but also maybe include some hours spent on the job. I do a lot of quality and safety work so it would be great to get some credit for that! 159I think more than 15 credits in 3 years should be required, closer to 24, 1 8 hour day every year, 160I think this is already met in our daily practice standards and current certification requirements. 161I would consider separating quality hours and safety hours as both involve different aspects of the healthcare process162I would not take163I‰??m unsure of how many CE‰??s is appropriate regarding quality and safety specifically.164I0165If there a another certification, then no more than 30 CEs combined. 166In some ways it should align with Part IV MOC of ABMS for physicians. The above seems steep unless we start identifying activities aligning with CE's for Quality and Safety167Increase CEU required + hours of practice 168Increase the CEUs to 45 every 3 years169It seems to me more CE‰??s would be needed to maintain a certification.170K171Leadership position on a unit or a Quality position in a hospital172Logistically I don't know how this work but anyone with this certification should show proof of some tangible work in quality or safety such as participation in research, performance improvement project, influencing legislative law, work on reaching quality indictors, workplace patient and employee safety committee, educational programs etc. CEU's are important but safety and quality are foundational to ethical healthcare. To claim to be distinguished from others, certified in safety and quality should require more than reading modules and taking a test. 173M, N = 4174maybe 7.5 CE175minimum176Minimum 15177Minimum of 15 per year 178Minimum15179Modify requirement if a concurrent credential is held180More in line with other current requirements for other certifications.181More than 15 CEs, maybe around 30.182My question would be, can these 15 CEs also be used in the general CEs needed to maintain my RNC183N/A, N =5 184NCC/EFM185No change in what is required 186no idea, N = 3187no more than 10 every three years188No more than 15 CE's every three years. Maybe have some of them overlap with the CE's required for the RNC-NIC or CCRN CE's.189No more than 15 ceu 10 is preferable. Because of that, If this certification is successful, those who hold it should be included in collecting data, assist in reporting all safety measures and any adverse outcomes,and continually assess the monitoring process, and have a dotted line relationship with quality officer in addition to the reporting nurse manager of the facility. 190No more than 5 CE‰??s every 3 years191No opinion192none Obtain many necessary ceu for other certifications193None, as we get some with our board certifying mechanisms. It would be redundant.194Not as many CE required, We are required for the State and national organizations we belong to specific number of pharm, nursing and midwifery CEs. Make the CE Available at low cost.195not as many CE's directly for this specialty196Not known197Not more than 30 CE's every three years although more than 15.198not required 199Not sure, N = 4200Of this is going to primary certification, then the 45 hrs/ 3 yrs would be required. If add-on like EFM, the 15/ 3 is acceptable.201Or provide summary of quality project202Or safety certification thru IHI203Or same as our other ones, I do the chart as I write my notes everyday because I read every note & order. I look for trends in a baby, staff or unit. I try to fix them right away so they don‰??t become issues. I DO NOT get much help on an issue for several years usually. Some I nip in the bud. 204other205Participate in hospital unlit this projects206Participate in ongoing QA projects.207Participation in quality and safety project. 208Perhaps it could be included in a the persons specialty certification as a sub-specialty, the same way EFM is a sub specialty of OB certification209Plus modolrdt210Portfolio of a project211proof of ongoing work and projects in field212Read articles on own 213Recommend at 30 to 40 CEs every 3 years specific to quality and safety. 214Research and Publishing involvement. If we do not require it be done by our 'specialist' it will not happen. Once specialist start projects it becomes infectious and becomes a habit that will grow. CEU's are often worthless and can be accomplished without effort or learning, they can be bought online for $$ and nothing needs to even be read or answered except I watched and this will improve my practice.215RNC in their area of interest216Same as current NCC standard217Should be optional218Should not require this competency because I am on the NE Quality committee already and we oversee these issues statewide. No one wants to have to get more credentials , etc. 219similar to other certification maintience requirements220Some number of CEUs, but 15 seems too many.221State 24 1 law certifications over 100 very expensive222Submission of a QI project that impacted safety and/or quality223submission of specific examples in each realm - processes and outcomes224The CEs are fine, but publishing or implementing effective programs in the field should be recognized as well.225the same number of contact hrs as an RNC-226Things like active participation in collaboratives, such as VON, or CPQCC, could be used as evidence of competence. 227Think the was NCC has moved to keep current in practice has been very positive228too many CME requirements already for MD's-apply to people who oversee quality improvement on system level229Try 5 cues every three230U231unclear at physician level as MOC incorporates a large portion of this232Unknown. 233Unsure, N 2234Up to 10 CEUs235V236Verification of working in a maternal neo setting 237W238We currently do CEs at my job online every year as a part of our competency. It is a few separate modules and it does a great job 239We have already and continuously go through perinatal safety and quality initiatives...240whatever you decide...241Why242Working in quality control243Workshop short term244Yearly report of contribution245You need 15 CEs/yr. to keep up with changes, minimally.Appendix SEQ Appendix \* ALPHABETIC M. Interest in the credential and perceived benefits – responses to open-ended questionsTable SEQ Table \* ARABIC 39. Likelihood in seeking the credential – responses to open-ended questionHow likely would you be interested in seeking this credential? VERBATIM RESPONSESIf not, why?190% of content mentioned is included in the DNP curriculum.2Academic track not hospital employee3Afraid of testing4After having been through your processes. It's way to disconnected from reality. No one other than the people that have the certification know what it mean. Its unorganized and difficult. 5All ready have two credentials6Already have 3 certifications to maintain. cost and time7Already certified 8already certified and will retire in 5 years9Already have 2 certifications than are more relevant and employer only pays for 210already have 3 do not get any money for it, why would I get a fourth?11already have a 5 year plan that includes additional education. would reconsider afterwards12Already have a credential and my facility only pays for one.13Already have a lot of extras to do for work 14already have certification in mnn15Already have it16already have many credentials, no time at this point17Already have RNC and CEFM18Already have RNC-NIC 19Already have this credential.20already have too many certifications that require so much CEU21Already have two certifications in my specialty area- more likely to do a leadership cert next22already have two NCC certifications and two more from other credentialing agencies, but have no opportunity to obtain a perinatal CNS credential - that would be the one I really need and have needed for over 25 years23already have two other certifications24Already neonatal high risk 25already overwhelmed by responsibilities. 26Already possess multiple certifications and it becomes difficult to maintain all27Already RNC28Although patient safety is a very important part of my clinical nursing job, I do not know the language and it would take alot of time to learn it. Also, I would not be compensated monetarily for an extra certification.29Although there is no specific credential for it now, it's not my primary job and there is designated education and management personnel who already cover this. I would consider it, if asked by my supervisor.30Although these are important areas of my practice. I feel like this is something for someone seeking a job more detailed in this area and is passionate about it. 31Am not looking for change in work focus. I enjoy clinical work.32another aspect of healthcare that will affect my practice, but not an area where I have any demonstrated expertise33Appears to be more specific to hospital based practitioners and administrators not those of us in private practice34As a NP in a private practice, I have little involvement, impact in any change of process and yet, see deficits every day.35As a staff nurse this credential would not benefit me. I would see this credential as being important to the unit manager. 36As above--I'm semi-retired. Only if I began working in a consultant role would I explore this credential.37As an overworked bedside nurse taking care of critical patients in a unit that is understaffed and overtaxed, I struggle to simply provide safe care. It feels like every tinme I go to work I am asked to do more- to CHART more. Another ‰?÷saftey‰?? checklist. Something else implemented. I wholeheartedly support and believe in evidence based practice and safety measures. However it seems the emphasis (at least in my hospital) has become making sure all of the boxes are checked. Instead of using the data to guide our care, we (the bedside nurses) are worried about data entry and not having a ‰?÷fallout‰?? (charting not complete). I can not imagine having to chart more. I can not imagine trying to implement MORE safety checklists. The actual physical care of the patients seems to have become less important than the computer. 38As long as I'm with my current employer. This facility is not interested.39At this point in my career, I am a bedside staff RN at a Level 1 hospital and have been so for 32 yrs. My interest is geared toward my practice, i.e: lactation and electronic fetal monitoring as well as obstetrical bedside nursing.40At this stage in my career it is not necessary and I've had my inpatient ob and efm certifications > 25 years41Back in school for my EDD42Barely time to do my job as it is!43Based on requirements and cost (already have RNC,OB and C-EFM.)44Because I am a member of the safety committee in my unit; I am always seeking out education + experiences to improve my evidenced based knowledge and skills that will enable me to contribute to the safety of our unit and hospital.45Because I am ready to retire soon. I don't need any more credentials46Because I don‰??t find it interesting 47Because it is extra time and money that ends in no benefits including time to do this or extra money. It is just a title 48Because it would add more work and more expectations and would not be financially beneficial. It would ‰??look good‰?? on my resume, etc., and would be appreciated I‰??m sure by my employer, but would just be another thing for me to do, and I already feel overwhelmed most days that I cannot do all for my patients/ families that I would like to do. 49Because one certification is supported by organization, sub specialties are not50Close to retirement, N = 11451Content 52Contracted for consulting work; intermittent employment53COST54Cost and Maintenance. I think that once you pass the test, conferences should be enough to maintain your credentials not taking a test and paying for modules. It‰??s a financial expense.55Cost and time may deter from obtaining this credential56cost is a huge factor57Cost is high, adds a third certification58Cost of credentialing and scope of this credential does not align with career path 59Cost of obtaining and maintaining especially multiple certifications.60Cost to me to obtain and maintain, not specific to my current job description 61Cost vs benefit 62cost, primary nursing focus63Cost. I have a CNL certification which covers similar themes, just not specific to obstetrics. I have over 20 years OB experience, so the CNL plus experience speak in a similar fashion without additional cost to me. That being said, I am proud of my position so would consider exploring. 64Cost/time limitations65Credentialed since 1994 as NNP, 1990 as RN66Credentialing is expensive to obtain and maintain. My hopital does not pay/reimburse for getting credentialed nor does having credential increase my pay in any way.67Credibility in the workplace.68culture of safety has to come from the hospital not an individual 69Current certification is sufficient70Current trending hot topic that has new labels for the same ideas don‰??t interest me. Trying to convince people nurses are smart and then nurses being the ones who stop us from using our brains infuriates me. Each year I‰??m told no we don‰??t do that it‰??s a scope of practice thing more and more. Well if you don‰??t do it you won‰??t learn any younger, nurses were the only ones in the hospital how do you think it got done? There weren‰??t dozens of meetings. A paper showed PGE worked you gave it. End of story. If 3 babies had an issue we figured out what was wrong and fixed it. No colored charts, months of meetings, and we may have had our fights but you were going to need to switch a night next schedule so you had to work it out like family. And when it got bad we got a unit therapist once a week for a year! Just like a family! 71Currently enrolled in in a DNP-NNP program.72Currently have RNC73Currently have three credentials and I spend a lot of time keeping up with the continuing education requirements. This is also minimally applicable to my current position. 74Currently in graduate school for advanced degree 75Currently pursuing my Masters and have two certifications already. 76currently too busy but would be interested in pursuing further later in my career77Currently traveling and not at any one institution long enough.78currently working for Pathways, that is a lot on our plate at this time79Demands of my current phase of life - 3 children, work full time. Maybe later on in my career. 80Do not currently do direct patient care. I teach childbirth education.81Do not find quality and safety alone as enjoyable or fulfilling. 82Do not have time to work on commitees83Do not need another credential84Do not need at this time.85Do not see the value86do not yet see the inherent value of it. Unless it required for privileges, the importance is not there. With all the other credentialing and recertifications needed, this would not have high priority.87Does not interest me88Does not pay for it89Doesn't increase my salary90Doesn't interest me91Doesn't monetarily help92Doesn't seem interesting93Don't have time or interest at current stage of my life.94Don't need it. Administrative or safety personnel in units do this already.95Don't want to96Don‰??t have time right now for additional work things97Due to my current age and retirement plan... but think it would be great program98Due to retire soon99Employer does not value more than one credential. I already have one.100employer expects lots of things that we have to pay to maintain but dont get reimbursed101employer has someone in this role102Employer only "counts" one certification.103Employer pushes these certifications and give prep courses for them and I believe this disvalues the whole purpose of the certifications where it should be to test the knowledge and judgement of the nurse, not study for a specific test.104End of my career will not help me105Expense and preparation opportunities. Will there be opportunity for a prep course in my nearby area?106Explained above...no benefit to me except less $ in my wallet107Feels like more of a CNS or nursing administration designation than practicing advanced practice.108Frankly, I only have 3 years to retirement after 45 years already and my energy for this is sputtering. We've come a long way, but have still a long way to go. 109Getting older. May not have time to complete certification.110Goals are more clinical knowledge based 111Great knowledge, but doesn‰??t feel applicable to my daily practice. Great for leaders and educators, but a little too ‰??meta‰?? for floor nurses112Hard to keep everything up113has nothing to do with working at the bedside, this is mgmt stuff114Have a lot on my plate already right now115Have it116Have two already117Hope to retire within 2 years118I already am certified in my specialty and a subspecialty. 119I already have a neonatal certification and am not involved in obstetrics/l&d/maternal health etc. 120I already have credentials that require maintaining and it would overwhelm me without financial gain. If I did seek this credential it would merely be for my professional growth. I have been a RNC for over 30 yrs, so maybe if I was just starting out on my career....121I already have my RNC-NIC122I already have my specialty certification in MNN, which is more suited to the work I do.123I already have NCC certification- wish you had not applicable as a choice.124I already have other certifications. Time and cost to get certified. It would be one more thing to try to maintain. I don‰??t get paid more to have an certifications.125I already have the NCC-Maternal Newborn Nurse Certification. My next step is to become a Certified Nurse Educator (CNE). 126I already have two additional credentials.127I already have two certifications, which is the max monetary benefit at my hospital. 128I already hold a management certification in addition to my specialty certification.129I already hold NCC certifications and I am primarily education. I just disburse the quality and safety information and assist with state quality projects. 130I already possess a certification 131I am 18 months from retirement.132I am 60 years old, and well established in my career. I am already NCC certified in Inpatient OB, and am not seeking another certification at this time. Possibly at another time. But I would recommend to others.133I am 62 years old, 40 some odd years of that spent as an L and D nurse. Somebody had to take care of the patients and not the theories.134I am 64 and enjoying my OBGYN Hospitalist position and supporting the culture of safety.135I am a bedside nurse. I do not evaluate data. I do implement safety and quality improvement.136I am a laborist and expect to retire from midwifery in less than 4 years.137I am a national expert in these areas. 138I am a travel nurse across various states, varies too much from state to state. Also hard enough to get my RNC-MNN recognized, this would seem like nothing.139I am about to retire140I am already a Certified Professional in Healthcare Quality.141I am already certified142I am already certified with Low Risk newborn143I am already certified....RNC-OB.144I am already credentialed as an NNP and have a hard time finding a job, don't think an extra credential will make me more marketable since I already have experience with quality from my previous professional practice. 145I am already double certified146I am already enrolled in school completing my BSN and plan to continue to acquire MSN.147I am already hold 3 certifications. It is costly to maintain and no financial reimbursement from my employer148I am at retirement age.149I am at the tail end of my career and it is not something I would be interested in at this point in my life.150I am busy maintains my current certification and participate in the hospital‰??s Clinical Ladder. 151I am certified but it‰??s getting expensive with CEU and all..I might give it up after this expiration. the institution I work does not reimburse of fund conferences152I am comfortable in my position and don't need added credentials.153I am currently a Neonatal NP. I would only consider a role like this if it were an adjunct to clinical practice and I was given dedicated time to focus on that aspect of my job. I fear I would end up trying to do chart reviews, etc, in between patient care encounters and the expectation for my output would be unrealistic. I am also curious about how one would prepare for this exam. Is there a textbook in development? An on-line program? I have no knowledge about the advent of this credential, but I do think it sounds quite marketable in the current healthcare climate.154I am currently certified in In-Pt. Obstetrical Care155I am currently enrolled in a DNP program at Frontier Nursing University that is QI-focused and many of the concepts included here are part of the program.156I am currently enrolled in an NP program so now would not be a great time to take on something new157I am currently interested in advancing my career through a holistic program. However, I have some coworkers that may be interested in this credential. 158I am currently semi-retired, although still working one day a week in the NICU. Not actively seeking further credentials.159I am currently working on my BSN160I am Director of Safety & Quality in my Dept. 161I am getting to retirement age and am not sure I want to seek more certifications. I am already studying for an informatics certification and at my age am studied out. 162I am happy with my degrees and my two certifications 163I am moving away from management into the NNP role164I am new to this role, so I still have a lot to learn. 165I am not highly involved in quality and safety initiatives. My primary focus is bedside patient care166I am not in management or quality. 167I am not inclined to do research 168I AM NOT INTERESTED IN INTERPRETING DATA169I am not interested in specializing in quality/safety...a lot of this in integrated as part of my job now and i don‰??t really enjoy it.170I am not interested in the administrative side of nursing as much as the clinical side.171I am not interested in this credential at this time in my career172I am not seeking to escalate my nursing career.173I am on the cusp of burnout. I am not in a position to add another task to my plate at the moment. 174I am only hired per diem. Units are presently too understaffed to permit staff to participate in education mock codes.175I am planning my retirement soon 176I am retired. If I were still working I would seek this credential. 177I am retiring in 16 months178I am strictly NICU would not be interested in OB aspects.179I am too busy with other projects at this time.180I am too close to retiring to want to sustain an additional certification181I assist with data collection but it is not my main focus.182I believe in an organizational structure and unit that supports safety and quality, but I'm not terribly interested in being one of the people that does data collection and interpretation.183I believe taking the RNC-NIC and passing was not a true indicator of my knowledge and nursing ability. There were many things studied that Are unnecessary to know ?? o the time. I believe less memorization and more understanding should be the focus. 184I can see this a credential for our quality and safety leads. As a director I utilize my resources and support quality / safety initiatives. 185I can't feasibly find the time or money to find certification in obstetrics186I cannot afford to pay for any more certifications. I am in if free!187I currently don‰??t work in a QI role. It would not benefit my career in clinical practice at this time. 188I do family practice so this is just a fraction of my job189I do not believe that Iwill have the time to persue this190I do not develop much of the measures for quality improvement or safety. I only implement as directed.191I do not enjoy this area192I do not have enough interest in this sub-specialty to devote the time to seek this credential. 193I do not need the credential to do what I am doing194I don't feel that it is very applicable to my job195I don't need any more credentials; just have to know how to implement the principles involved.196I don't need it197I don't think it would benefit me in my small private practice. (Staff of 3)198I don't think my organization would care if this certification was obtained or not. 199I don't want any more job responsibilities. I am too busy to take on new responsibilities. 200I don't want to have to pay for another exam.201I don‰??t feel that the potential benefit if any would be worth my personal cost in time202I don‰??t have an interest in quality improvement 203I don‰??t have the time.204I don‰??t know much about it 205I don‰??t work in a NICU206I enjoy patient care207I feel that the safety program that we are already involved with and programs related to quality initiatives and research instituted by the hospital for my position are constantly increasing my knowledge 208I find the subject important and seek to help improve quality and safety but it is not my focus. 209I have 3 certifications already 210I have 3 credentials already211I have a busy schedule and i find it difficult and expensive keeping all my credentials current.212I have been certified in inpatient ob since 2006 and EFM since 2009! 213I have done QI previously for many years. The key is to have accurate results, and electronic charting (although awesome when charted accurately and properly) has so many variations to how staff/clinicians chart, it makes it difficult to to obtain accurate results.214I have enough stuff on my plate and it won't benefit me on my wages and current position as a staff nurse. I feel this is better equipped for administrators. I do think nurse should be aware of it though.215I have enough to keep me busy and informed at work and am not seeking to advance my career beyond my present position (staff CNM and director of a midwifery service)216I have it217I have my certification 218I have my RNC219I have three certifications already so I am not sure if I will add another.220I have to get credentialed for education221I have too many certifications.222I hold certifications in Inpatient Obstetrics, Childbirth Educator and Fitness Instructor. I'm also pursuing a graduate degree in Nursing so this credential is not in my path.223I hold one certification through NCC, and I am working on another through execuative nursing leadership.224I just want to do my job taking care of babies. That's my strength, and I do it very well.225I keep up to date with new info, I do not get increase in raise. The process is expensive and I am retiring.226I know this is necessary, but not my area of interest and I do not want to go back to school.227I maintain NCC certification in Inpatient Obstetrics and am pursuing NE-BC certification as well. I am not interested in pursuing an additional certification.228I need to learn more about this certification to know whether it would be beneficial to obtain it and whether it would help my in my current practice or help me in future goals.229I only participate in quality data collection, presentation and meetings because management pushes it on the staff. 230I perceive I am at the end of my career231I plan to change specialties within the next two years and this certification will not enhance my career change.232I plan to retire within the next few years.233I prefer clinical practice.234I prefer direct patient care. I would participate in designated projects but not initiate or lead in this type of role.235I prefer to just be at the bedside and remain certified in direct patient care236I retire March 2019237I want to stay at the bedside and I retire in 6 years. I am currently involved in a project that will take all my extra hours and will continue to focus my energy there238I was not aware of this certification.239I will be half time in the very near future with the goal of retirement. Otherwise, I would definitely consider it.240I within 2 years to retirement.241I work long hours as I try to be available for parents who visit at night and I have a family.242I would definately need a review course and references243I would do it if my hospital mandated it, but otherwise, I would definitely use my personal continuing ed money for other courses. I don't feel like my organization is very open to initiatives from providers. If it didn't come from the corporate headquarters, it is dead in the water. 244I would have to complete the education/training/credentialing in my spare time. THEN I would have to perform the tasks related to the sub-specialty in my spare time. 245I would like to participate more actively in planned change in my specialty.246I would need support from my employer (paying for the education) to even consider it. Considering that they won't pay for me to go back for a MSN, I don't see that happening.247I would need to do a lot of educating myself to obtain this credential and I am not clear on what courses or online educational opportunities are available to make this possible. In my current job role, I am not tasked with most of these things, but I could see it as a future benefit in a different job role. 248I would need to learn more about the steps involved.249I wouldn‰??t get credentialed if it did not financially benefit me at this time 250I'm 65 years old, don't see career value251I'm already certified and hope to maintain this designation. If I lapse, I will not reseek. It's too much work to not receive anything in return.252I'm already have CPHQ (Certified Professional of Healthcare Quality) certification which is widely respected as the gold standard for quality certification. I'm not sure there would be value in obtaining an additional quality certification. 253I'm busy enough already and don't have the interest required.254I'm completing my MSN in education and changing my focus to teaching. I am planning on obtaining my CNE right now,255I'm looking to retire in the next 5 years, I'm winding down256I'm maintaining 2 certifications in addition to maintaining continuing education for my job - I'm not looking to add more tasks to my life. I want to stay at the bedside, encourage continuity of care by encouraging consistency in nursing staff to their patients. - 257I'm not sure this is really looked at/needed yet in the nursing profession in general. Only if someone is really involved in this there may be a need to have this specialty.258I‰??d rather see NCC recognize the education that CNMs have and allow testing for WHNP certification without further needless education. The WHNP educational track is the same as the CNM educational track MINUS intrapartum care. 259I‰??m already certified through your company!260I‰??m close to retirement. I get the most satisfaction from one/one interaction with patients and patient advocate.261I‰??m focusing on maternal child and becoming IBCLC certified and moving in hat direction towards retirement. The incredible demands and short staffing of any unit I work on is too much stress!262I‰??m in my 50‰??s and am an RNC and that‰??s good for me at this point. 263I‰??m not into research and EBP264I‰??m not sure how this credential would help me as a staff nurse who has no desire to be in the management role. 265i‰??m not sure yet266If I worked in that department I might consider it as a part of my credentials but as a staff RN I feel I have enough to keep up with maintaining my OB certification and knowledge. 267If it is in addition to my CPHQ credential 268Improve patient outcomes269In my current role in the military, it wouldn't benefit me at all270In my experiences, I'm not sure how valued this credential would be within all organizations271in our institute we have a team of quality and safety "officers" who are present for all projects and guide us through these steps. As a Nurse Educator I feel that my attention can be focused elsewhere for certifications such as a certification in Nursing Education. Thanks!272In school273interesting but no benefit back from my institution274It adds burden to MOC275It doesn't really benefit me as a floor nurse. There will not be any recognition for the effort made.276It is an area I am interested in 277It is beyond the scope of my usual job duties and would just be an expense to me personally. I would receive no benefit from my employer for seeking additional certification.278it is important but is totally boring to me. 279it is not an area which I choose to specialize in280It is not necessary for my current academic role in my institution and would not necessarily provide me with new information.281It is not needed, especially for non-management positions282It is not something that I would want to pursue283It seems we have ALOT of staff at all levels involved with quality and safety and I feel they are doing a good job284It will not make a difference at my workplace. 285It won't help me in my job. My employer does not currently take this seriously. They want NCC certified people but they don't want to give us a salary bonus or increase for it. It's not worth it.286It won't likely be paid for by my employer and I will not be able to afford pursuing it myself.287It would appear that this certification is for Nurse administrators who would probably benifit more if they took patient assignments on a weekly basis. Nurse administrators need to work at the bedside if they are to ever really improve the quality and safety of the care of mothers and newborns!!!!288It would be an added cost that I wouldn't see a return on. Also, as a staff nurse very little of my time overall is used for researching or changing anything. My thoughts aren't valued.289It would be important for organizations to understand and recognize the importance of this certification290It would improve my job satisfaction if I could improve quality291It would not benefit me monitarily292It would not help me advance any in my current position293it's not my specific sub-specialty area of interest294It‰??s not a aspect of my job that I spend a lot of time doing295It‰??s not my ‰??thing‰??296It‰??s not my primary focus in my career.297It‰??s not recognized currently at my organization for physicians 298It‰??s nothing more than what we already do. Costs too much, and is all for the sake of putting a brand name behind our knowledge 299just doesn't interest me; I prefer taking care of the infants with safety and quality measures/interventions300Just not an area that I have a passion for 301Just not interested302just not interested in pursuing303Keeping up 3 credentials presently304Knowledge is power305Lack of opportunity at current facility.306Lack of time, N = 3307Limited knowledge to begin with in addition to the lack of experience. 308Looking to transition to another role 309Love staff nursing. No longer in management area. 310main work is in education, clinical practice is a small part of my role311Mainly for professional development only. Doubt will be recognized by employer, doubt it would open other job opportunity within the Advanced practice group, and definitely doubt that it would increase my salary as obtaining my DNP did not increase my salary.312Maintenance in one credentialed area already313Maybe314Maybe if I was younger.315maybe relevant for a QI person not me personally316More interested in hands on clinical aspects of care; seems rather dull.317More interested in other areas of practice 318Most of my responsibilities are in academia and trying to stay current on practice changes across the role of the NNP is challenging enough.319Most of this is beyond the scope of my current daily practice320most of time is dedicated to basic science research, and that is my priority321Most places I know struggle to stay appropriately staffed. Having someone whose job is to tell overworked and often frustrated staff members how they can do better is great for administration and press releases but does precious little for the individuals providing care. Anonymous peer reviews are still commonly used and are mostly useless methods of sniping at a coworker. Many of the adverse event reporting tools are cumbersome, time consuming and often will not allow for certain events to be reported if they occur outside specific parameters. They are touted as wonderful reporting tools but in my experience are rarely used, despised by staff and often manipulated to focus on the failure of the individual rather than how to best prevent an event from reoccurring. This would be a wonderful job in a Utopian society, not the real world.322Moving toward nursing informatics in general for my career323My age and current work environment324My current focus is on development of our Perinatal Palliative Care Grouo325My current job is for direct patient care and I don‰??t have anyone at my current organization offering to mentor me in this area of expertise. Even though I work for a CWISH Hospital, there is little focus on educating staff in QI initiatives.326My employer has two positions for quality/safety planning and generally do not plan to add additional staff to this area in the near future. Although taking part in meetings is encouraged, time away from the floor/bedside care is also somewhat frowned upon. Having a certification in quality and safety as a subspecialty of obstetrics/neonatal care would not benefit me in my current role, however, I could see how having certified nurses in this subspecialty may cultivate a better culture of safety at the institution.327My employer will not pay the cost of the exam and it will be very expensive for me.328My entire career has been focused on direct patient care. I have no desire to be distracted by an alphabet soup of acronyms329My focus is clinical experience. QI is certainly important for optimizing clinical experience and outcomes but providers have to have a grounding in the basics of care to offer any care. 330My goal is working with the patient population, not spending all my time in research. I value my time working with laboring patients throughout their whole stay. Research is important but not my forte'.331My heart is in clinical practice 332my hospital doesn‰??t give a hoot about most of this stuff.333My job in management does not leave time to pursue that sort of credentialing.334My organization only financially recognizes one certification per RN. It would not be financially beneficial for me to have an additional certification at my own expense and it would not serve to advance my current career. My organization does not invest in the bedside nurse safety335My practice is education and not at the facility level other than student clinical experiences.336My role as a staff RN requires knowledge and implementation of these safety and regulatory practices, but I do not collect data. I train many of our new RNs, so I need to be aware of existing policies and protocols and learn new ones as they role out. I don't have a large role in developing new protocols at this time nor do I have a role in management.337My role depends on quality & safety work but I am not primarily involved in the data collection ore review. My focus is on rolling out the changes.338My role is low in the organization, and while these things may be of importance to me, I feel it is not important to my leadership. This is based on past experience of trying to implement projects or education.339My role is not in this area. I would seek credentialing in other areas ahead of this one.340N/A, N = 16341NAHQ342NCC maintenance costs and I get no added benefit from my employer; not in my job description343Never heard of it, and most of the language in the survey is over my head, too. I have a BSN and my RNC-MNN. Based on my reading and clinical experience, this survey is gauged toward those at a Master's level or higher. Please send surveys with more relevant language and questions.344No benefit at my current facility. 345No benefit for my job 346No benefit in my current job347no desire, no benefit348No financial benefit 349No interest, N = 5350no interest in it. too close to retirement351No longer in a leadership position352No monetary benefit353No money back for what I invested to take test and recert354No more money355No need for it in my position356No pay benefits or recognition by employer Too much right now 357No Pay increase for it, and not recognized by employer-on name badges, so also not recognized by patients and families.358No pay raise or reimbursement and we have to pay to maintain.359No pluses only expenses 360No salary increase, no job change.361No time, N 5362no time, no pay, no raise in pay.363Not all of this used by my employer. I'm not aware of what all of this means.364Not an interesting subject365Not applicable at this time with resources available 366not area of interest 367Not critical to my practice. No time. 368Not currently emphasized in my practice location. My day is 100% focused on patient care, minimal time for additional research, implementation... as much as it is needed.369Not currently something my role would look in to but there are others in my facility that might.370Not enough free time to do this.371Not enough interest in developing this aspect of my current nursing role at this time 372Not fitting for my role 373Not in a direct quality administrative position374Not interested, N = 15375Not interested due to my age and current career goals. In addition, I see too many other certifications similar to this proposed credential which are highly valued and even required for many positions.376Not interested in those politics 377Not interested. At all. I work in a small unit. My ‰??team‰?? is often myself and 1-2 other nurses. 378Not interested. I recognize a lot of it through education in our unit but it‰??s not for me. I‰??m very involved in other areas379Not involved enough in the setting up of standards and collecting of data, other than direct patient care reports and measures380Not involved in these areas381Not much benefit to me in my current role382Not my area of expertise383Not my area of specialty but looks interesting and important 384not my focus 385Not my personal area of interest, I am more focused on direct patient care as opposed to research or quality improvement.386Not my preferred area of specialization.387Not needed, N = 9388Not personally interested in data collection and evaluation.389Not planning on changing my job. 390Not possible given current job391Not really needed for position/advancement at this time392not recognized , not important to be certified, not needed or encouraged. have to pay for it myself, 393Not recognized as valued in my academic setting.394Not recognized or encouraged by my employer 395Not regular part of care of bedside l&d nurse396Not related to my career.397not relevant to my practice398not required399Not respected in my organizatin400Not something I want to devote my career to right now. 401Not something of interest for me402not sure if needed403Not sure the organization will value it404Not interested405Not through NCC. 406Not too interested in pursuing this407Not valued at my facility.408not valued by my employer409Not interested410Not where my interest lies. However, there are some midwives who this would be perfect for them. This seems like a good certification for our midwife leaders/directors and the midwife who manages our statistics. 411Ns412OLD. plus how many people in one unit need the certification versus being lead and mentor for unit. will all certified really change the perception and or particapation of adminstration of RNs and or advanced practices nurses. give it a shot maybe i will live long enough to see nurses as equal participatents in health care413only barrier would be current heavy workload and time required to achieve credentialing414Only provides for my professional education. There is no other monetary reason to obtain. 415Other personal and professional priorities ahead of this certification.416Other topics interest me more 417others in the dept will take on this role and disseminate the info to the rest of us.418Our institution has their own Credentialing 419Our institution is financially in trouble and minimal quality work is being done.420P421Part time but information is vital in optimal care of my neonates422Personally, there is no benefit to having this sub specialty. I work for the military, and I am not in a leadership position. I am told what to use, not in a position to change practice. 423plan on retiring next year424Plan to retire in next few years. 425Planning to retire426Planning to retire soon, otherwise I would be interested427Prefer direct patient care428protected time, direct patient care, patient work load429Quality and safety is part of all of our jobs. I don't see the added value in this certification.430Quality and safety, like clinical care, is a life-long commitment to continuous improvement. Credentialing may be seen as either something everyone must do (in which case it's just MOC by another name); or it's something that 'someone else does, but I choose to focus on other tasks'.431Quality initiatives promoting safe practice are the essence of facilitating positive outcomes of OB/NICU care432Quality is ta fundamental responsibility of a CNS433Rather stay more focused on bedside care. 434Close to retirement, N = 114435Really no reason to obtain in my current job position436Requirements for current certification is enough for me. Additional certification will not provide advancement or raise in pay at my place of work. 437Retired N = 2438Retired, working part time as adjunct faculty439Reviewing these questions, it is clear to me that much of the content is not within the everyday job description of the average staff nurse. It is not information that can be aquired on the job.The only people seeking this credential would be people who already have advanced degrees and are already in career areas of nursing administration or education.440Safety important to me441See above, N = 3442See above. Cost of maintaining is not beneficial to me. 443See previous comment444Seems more beneficial for management vs a staff nurse. Although helpful information. Staff nurses don‰??t get to spend much time on development and implementation of safety practices. 445Semi retired446semi-retired and working part-time447Semi-retired. Have 4 NCC certifications to maintain448Some of this content just does not interest me. I do feel like it‰??s important. 449Sometimes, the letters after a person's name mean they took the time (sometimes away from their jobs) to pass the tests (or study to the test). Unless the NCC decides to honor the commitment we professionals have made, the credentials are just more letters after a name.450Sounds very boring, N = 2451Teach associate degree students452The cost/benefit is not balanced. My organization does not reimburse for a sub-specialty certification, if I already have a specialty certification. There is no added benefit in my professional career at the organization to obtain this, and would not add except for portfolio if leaving453The ONLY THING I am interested in is becoming a nurse advocate - because nurses have NONE! Someone needs to step up to the plate and demand that nurses have humanity, dignity and respect. Nurses are like cattle being sent to slaughter. There will be an enormously frightening situation not too far down the road where there will be no one who wants to be a bedside nurse... Ane where will that leave us. There is an overwhelming ignorance and lack of foresight in the present nursing leadership. They do not have their eyes open acknowledging the fact that there is a huge problem that is looming in the not so distant future.454The themes are too vague to interest me. I was terribly bored taking this survey.455there are defined roles in the hospital responsible for this456there are so many other subjects i need to study and test for to keep up my credentialing and it is becoming expensive. I do not get the recognition in pay for the certifications, it's my own pat on the back457There is no benefit to me and I'm not interested in spending more time on CQI projects at work.458There is not a benefit for me to gain this certification. The hospital does not recognized extended knowledge.459These goals should be part of every working practice. To some or a great degree they are part of professional behavior and ongoing learning and should not require subspecialization or certification. There are national and international bodies(VON) that collect data on outcomes. There are local institutional bodies that look at local practices. While I understand the wish for greater adherence to national standards, this has not been able to be integrated in either the obstetrical or pediatric world respectively, let alone the two worlds together. The implementation of many of the goals are beyond the scope of practice of the practitioner and require close integration with the institution - these are profit making entities, that do not always wish to invest in greater than the minimum standard ventures. 460this area is divided up into many different factions in my workplace461This certification would benefit me in my former job - where I was an administrator for the service and spent ~ 40-50% of my time on these topics. My sense is that many hospital systems have implemented individual parts of these training programs, especially for high level leaders462This is a high priority in the NICU I work in. 463This is an amazing direction to grow certification. This would encourage nurses to further develop the topics of quality and safety unique to maternal and newborn populations. Great plan. 464This is more redundancy in the nursing profession- not interested!465This is not a large focus of my position.466This is not a particular area of interest for me467This is not an area that holds my professional interest at this time but perhaps in the future.468This is not an area that I am interested in. 469This is not my area of expertise.470This is not my area of interest. However, it will be of value to people looking to work in this area. 471This is not my primary focus in my current job. I would be likely to seek other credentials.472This part of nursing does not interest me at this point in my caeer.473this stage of my professional developement I am phasing myself towards retirenment474This would likely be of value to the institution only for staff who work in the quality improvement department. Also, I am juggling a number of other projects at this point.475Time constraints, N = 6476Time & money spent477time and attention spent on MSN NNP degree right now478Time and commitment required to complete would be limiting factors479Time commitment480Time constraints and other priorities as a leader481Time consuming in a very busy high acuity speciality482Time, $, 483Too academic484Too costly to keep up education along with other certifications and dues485Too detailed for my interest486Too expensive for very limited return. I love the idea but will not be recognized by employers for certification 487too late in my career. if it was 10 years ago, I would have liked this488too many certifications to maintain currently; burnt out on studying and taking certification exams489Too many other areas I need to focus on490Too many other more important aspects of neonatology to be involved with491Too many other obligations492Too many requirements already with fetal monitoring and licensure and board certification maintenance. I teach all of this so should automatically be an expert. 493Too much not applicable to my position 494Too much on my late at present. Short staffed. Long hours495Too much work to do already not many hospitals are going to pay someone just to do this position. Would be interested if that was your only responsibilities.496Too much work. But I realize that it is important for professional growth as a leader in neonatal care.497Too old498Too old and tired!499Topic not interesting to me, personally500transitioning out of hospital based care to private consulting after 25 years501unable to commit at this time502Unfamiliar with job of safety/quality coordinator503uninterested504Unless these practices are build into the clinician role with appropriate time to complete them, this is a very unattainable goal.505Unlikely to get paid for. 506Unrelated to job507Useful and helpful for improvements 508Very close to retirement and not looking to acquire any more credentials 509Very likely, but also would consider the national Patient Safety Certificate that is general population, not Neo specific.510Very specific focus 511Waste of time/ money512We have a hospital quality and patient safety RN that this certification would suit perfectly. As a professional development consultant (nurse educator) my work requires a good understanding of quality and safety components but it‰??s not my area of expertise. 513What courses are provided to get this credential?514While I feel the results are important to read, I have no interest in being one of the persons doing the research or data collection515While it would make me a more well-rounded nurse, it would likely not help me further my specific career goals.516While the information is important, the credential is not. 517Will be determined by impact on time and cost. Right now I am so busy doing the work I will need to evaluate if the time, effort and cost will have any true benefit to me. Nice to have but balanced by cost of getting it518will help my promote good practice 519Will not affect salary520Will not be utilized by my institution 521Will not benefit me522Will not directly affect my role. My employer does not provide and incentive523Will not increase my salary. 524Will seek credentials525within 5 years of retiring526Work 8 hrs/we. 20 years ago: YES527Working in pre-hospital care, most of our quality and safety initiatives are specific to this environment and patient population. There may be some irrelevancies for my particular role. I love this idea, however, and hope it is offered, as I see it being a great step forward in healthcare. 528Working on other professional goals at this time529would add personal value, but no workplace rewards. already have two specialty credentials. 530Would need to evaluate the benefits of obtaining the credential 531would not affect my career advancement, not planning to seek new professional opportunities, personally not in position to seek additional roles532Would not benefit when when it is already required for employment. Time vs cost and recovery of cost to accomplish task533Would not increase my pay and not of great interest to me. 534Would not increase salary 535Would not use this as a staff nurse536would rather do another credential537Wouldn‰??t benefit me at this point in my career, no time to do it. 538you must work in a facility that makes these areas a priority. I do not. So therefore it would be a waste of time for me.Table SEQ Table \* ARABIC 40. Benefits of the credential – responses to Other(please specify)How will this credential benefit you? (Select all that apply.) Other (please specify) VERBATIM RESPONSES1Extraneous marks, N = 32.would not increase salary 3A, N = 34Ability to influence process, safety, and outcomes in my setting and community. 5Advanced knowledge 6Allow me to be more proficient in educating others especially trainees7Allows patients and public to realize the emphasis place on quality and safety.8Amount of $ I pay out of pocket for CEU's exceeds the $ I receive from my employer to be certified. It is a SCAM, pure & simple, designed to screw nurses. 9An 10Any credentials that enhance patient care outcomes, is truly beneficial for an organization. 11As Certified Maternal Newborn Nurse and a Certified Professional in Patient Safety this is very interesting and exciting to me. 12Assist fellow staff members in improving their practice13Because the government wants to try to keep some control over the med field14Because these are essential to my role, it is the right thing to do and will encourage professionals to seek out continuing education. 15benefit my patients16Better work environment 17Better. Safer, care if entrusted Neonatal patients18C19Career ladder program-make me a more knowledgeable nurse 20comment21confused as to what credential you are speaking of? My specialized area is very beneficial but if asking if I would seek a quality type certifications I would not.22Currently there is no benefit.23Demonstrates a commitment to being credentialed in quality and safety measures that have nationally been established24Desire to learn more personally.25Do not know.26Do not see benefit 27Does not add anything from employer status 28doesn't change my work ethic or future opportunities29Don't think it will30Don‰??t think that it would benefit me from salary perspective, and would probably only add more to my plate to get done. Honestly, most clinicians don‰??t have the time in their usual day or week to do things like this, although in ideal world it would be great! There is not set-aside time for this type of project‰??patient care must come first. 31doubt that I would pursue this32Educational opportunity33Effort should be supporte. No direct benefit to me34Evaluating systems and processes through a more structured format that includes safety and quality would increase patient safety and is an area of nterest to me. 35for my personal development36For my situation, my salary does not increase any longer just based on my certification (it did when I was first certified). My certification is based on my job and not on a different opportunity.37G, N = 238Gave me more recognition with coworkers as a resource 39Given monthly stipend for RNC40Greater understanding of new legal aspects of health care41H42Had certification for years because was a personal goal for me then it became mandatory without any employer provided benefit. Employer did provide cloth tab to wear with the ID badge to show the public. 43Having the knowledge and the understanding how important the safety of out patients and how to prevent and intervene is very important.44Help me gain increased insight into improving safety and quality in these specialty areas.45Help me to promote more focus on the importance of quality and safety and it‰??s impact46Helps with magnet47Hopefully it will improve the quality and safety of care that patients at the bedside receive 48Hospital administrators provide funding49How will this be different from the Certification as a Professional in Healthcare Quality (CPHQ) offered by the National Association of Healthcare Quality?50I am a staff nurse who serves as the chair of our unit based council as well as the chair of hospital wide Quality and Patient Safety Council. 51I am currently CPPS through IHI/NPSF and would be thrilled to see a more OB specific certification! Culture and Safety are critical to the success of an organization and our patients deserve certifications like these by the front line staff in order to engage them in the process! 52I am thinking of dropping my certification53I am very involved with my current director as the clinical liaison for training and assisting with our OB designation and perform most of these tasks frequently in addition to my clinical responsibilities. I feel this would allow me to have more respect with upper management. 54I currently run this credentialing for my program.55I didn‰??t know it existed. I have no desire for this but there is a need for that role. It‰??s just not my thing56I don't know, N = 257I don't know that it would58I don't think it will59I don't think it will benefit me at all.60I don't think it will have any impact61I don't think it would benefit me in my small private practice. (Staff of 3)62I don‰??t have it63I have no idea if it would benefit me....64I have personal experience of safety reporting that has cost me my position as well as threatened my license. We must hold hospitals and individuals accountable to the safety of their patients, and ensure that working toward safety never threatens the reporter.65I hope to improve patient outcomes and increase safety. I also would hope to find meaning for myself within my position through making a positive difference for others.66I love QI. It is my passion and I want to improve my skills.67I probably wouldn‰??t try for it68I teach this course and it would provide an additional recognition. 69I would hope my salary increases, however, my institution doesn‰??t appear to value (monetarily) certifications70I would understand and apply needed information to my practice71I, N = 572I'm unaware of this credential and I highly doubt my manager would place value on it73I‰??m retiring 74I‰??m very proud of my certification!75I‰??ve has this since 198576Improve knowledge, N = 377Improve patient outcomes78Improve safety & care for my patients & families79Improve the overall safety in the OB/Neonatal areas80Improve the quality of my own practice81Improved patient outcomes, consider implementation of new strategies to improve patients outcomes and experiences in the Neonatal and Obstetrics units82Improved patient outcomes, improved team dynamics and Satisfaction, engagement83In the past I worked for hospitals that valued those RNs with NCC credentials. They actually felt that this should be the ‰??norm‰?? and as such compensated staff who had this. I now work in a level 3 regional OB/NICU facility that does not compensate nurses. On my unit only 2 of us have our credentials. The differences I have experienced among others it‰??s lack of commitment to our specialty, high turnover of staff, and lack of knowledge in current ‰??best practice.‰?? As such, I see many of our patients experiencing an increase in maternal/fetal complications that could have been prevented if nurses were better trained/educated. 84increase community confidence in the organizattion85Increased awareness 86Increased knowledge and understanding of principles of quality and safety will improve my patients' care and outcomes. Certification will give patients increased trust that they will be cared for safely and to highest standards.87Increases knowledge base in my practice and justify the culture of safety principles I teach88Interest in results no time to participate always want to grow in providing care89It costs more to maintain a certification than we are compensated. It is not beneficial for me to become certified. 90It is imperative that we have leaders to promote improving the quality and patient safety of mothers and babies. The United States current perinatal morbidity and mortality is deplorable. There is so much we need to do. I plan on being a part of the solution. 91It is not no increase pay, employer does not reimburse for certification or ceu92it likely won't. i already have 2 certifications and the hospital only acknowledges and reimburses for 1 certification, regardless of what it is.93It no longer does94it really helped increase my knowledge and better my patient care.95It will not provide benefit in my organization 96It will not, as I am in Transitional care97It won't98it won't99It won't benefit me100It won't benefit me, because I am not familiar enough with the content to ever consider this credential.101it won't make a difference102It won't since I'm semi-retired and only involved on the fringe of quality and safety initiatives.103It won't., N = 5104It would not help me.105It would not in my facility 106It wouldn't107Job requirement108Job security if layoffs were to occur 109K110Knowledge111Knowledge will surely benefit and improve my practice.112lets patients know that their caregiver has a higher level of expertise113lifelong learning for growth and professional development/opportunities.114M115M116Mandatory117maybe for new job118Maybe interesting if it‰??s different than the same old thing everyone else offers 119Minimal benefit120Mostly prof development121Much knowledge aquired122N/A, N = 21123Needed for my APN license124Never heard of it, and most of the language in the survey is over my head, too. I have a BSN and my RNC-MNN. Based on my reading and clinical experience, this survey is gauged toward those at a Master's level or higher. Please send surveys with more relevant language and questions.125New info126No benefit, N =16127No comment 128No interest 129None 130None cuz hospital won't pay for more than 2 certifications and also only pays 1$ hour more for it131Not, N = 3132Not applicable, N = 4133Not at all, N = 3134not beneficial to me135Not likely136Not sure, N = 5137Not sure that it will at this point in my career. I think it will be important/have value for organizations.138Not sure what credential you‰??re talking about.139Not sure what the question is asking140Not useful unless a management career track is chosen. Certification doesn‰??t have any effect on pay in my state.141Nothing will change142O143Only get pay increase for one specialty 144Only self improvement my hospital will not pay more or give any plus for doing145Open lines of communication between healthcare and community146organization recommending being credentialed by different quality specialty - not sure I would take this one147Over 90% of RNs in my unit are EFM certified148perhaps give new ideas of how to implement more quality and safety improvement in my current clinical situation.149personal150Personal commitment to safety and process improvement. For example, a nurse on our unit recently gave a newborn a tetanus (maternal) booster instead of its Hepatitis B vaccine. These errors should not happen--why was the nurse not following scanning protocol? Why did she believe she read the correct medication on the label? I work both in the unit, and as a university educator. I want to be able to help nursing students avoid such work arounds that can lead to life-altering sequelae for patients. Especially as the news this week has turned to how unsafe it is for women in the U.S. after birth. Having such certification in a "closed" hospital-type unit (not affiliated with scholarly research, could benefit by providing the argument of why we should analyze such occurrences seriously. 151Personal growth and development152Personal professional growth and satisfaction153Personal satisfaction, N =2154Personal satisfaction of providing patient care improvement. 155personal/professional pride156Personally want it so I can leave current employer and move to better culture of safety157possibly158Possibly the above159Professional development 160Professional gratification 161provides a sense of personal pride and accomplishment162Quality and safety are already critical aspects of my role. Having a credential will show I can pass a standardized test on the material but doesn't show how I use the knowledge. This might be helpful for a new APRN who doesn't have job information, not necessarily for a person who has been performing a high levels for years. I am not currently credentialed as a CNS because NCC doesn't have a credentialing process for this in my practice area - yet I function at an extremely high level and am highly specialized - it is a problem with the credentialing process, not with the skilled professionals who live the experience on a daily basis. The ability to pass a test shows the person has studied the material expected, not that the person can perform at an advanced level. 163Quality and safety are important in my practice.164Quality and Safety initiatives can improve patient outcomes, this is a crucial benefit to a specialty certification. Increasing awareness in this field in important.165raises awareness to patient/public166Random survey167recognition and resource from and to peers168Required by employer, N =5169Required for licensensure 170Requires self discipline on my part and the idea that I alone want to be able to provide the best and most knowledgeable care to my patients.171Resource to young RN‰??s172Respect and professional authority in committees related to patient safety and evidence based practice173Retiring174S175safer patient outcomes176Self fulfillment, strengthened ability to inform others177Self knowledge, pride in accomplishment178self satisfaction179Serve as a mentor and guide newer staff to quality and process improve to Quality and the healthcare and outcomes childbearing women and infants 180Serve as a role model for professional development of others181T182Thank 183This certification does not make me a better nurse. With no additional pay and out of pocket recert expenses, that all must be pre approved by NCC, Overall opinion in our hospital is it‰??s unnecessary 184This is a great credential! 185This is an area that is growing rapidly. 186This is purely for my own professional growth. I receive nothing from my employer for being certified.187This sub specialty would help me in the preparation of classes that I teach and reports that I make. It will also help me to help staff understand the benefits of some of these qualities188This will improve the overall understanding of exactly how to communicate on all levels within the hospital setting about safety initiatives. 189U190Unfortunately hospitals just put people in charge of quality with no specific training or credentials for this work191Unknown, N =2192Unsure, N = 2193Unsure that my employer is aware or uses this in practice. All this time should be worth a ce credit, not a chance prize.194Validates my training and years of experience to patients, coworkers and Physicians in day to day practice and out of facility events such as conferences and in court. 195Was required to remain in current role or be demoted 196We get no extra benefit for being certified. It's a personal opportunity 197Will not - wow this is the most cumbersome survey I‰??ve seen. How does one distinguish critical from adjective critical. 198Will not be valued in my academic setting. But if I were in clinical facility would be recognized.199Will not benefit me, N =3200Will not benefit me... These people will be drinking the coolaid and be quite thoroughly brainwashed. They will have a new job position which will be to manipulate and brainwash the staff. Yet another person in a position of power to waste time, energy and money and accomplish absolutely nothing.201Will not in my current practice202Will not matter203Won‰??t 204working in a busy University NICU-always learning...205Would be in alignment with my current NICU specialty, nursing administration and quality/safety certifications CPHQ & CPPS206Would greatly increase my knowledge and hopefully improve quality and safety processes that I am responsible for.207Would like to promote safety209Would not benefit, N =3210Wouldn‰??t impact unfortunately 211Yes 212Z ................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download